Provider Demographics
NPI:1538215264
Name:MEHTA, GITA (MD)
Entity type:Individual
Prefix:DR
First Name:GITA
Middle Name:
Last Name:MEHTA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:330 LEWIS ST SUITE 301
Mailing Address - Street 2:MAIL CODE - 8201-A
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-8201
Mailing Address - Country:US
Mailing Address - Phone:619-471-9278
Mailing Address - Fax:858-534-9794
Practice Address - Street 1:330 LEWIS ST SUITE 301
Practice Address - Street 2:MAIL CODE - 8201-A
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-8201
Practice Address - Country:US
Practice Address - Phone:619-471-9278
Practice Address - Fax:858-534-9794
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA45647207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C58387Medicare UPIN