Provider Demographics
NPI:1730341181
Name:MEHTA, MITUL (MD)
Entity type:Individual
Prefix:DR
First Name:MITUL
Middle Name:
Last Name:MEHTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:200 S MANCHESTER AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3219
Mailing Address - Country:US
Mailing Address - Phone:714-456-2986
Mailing Address - Fax:
Practice Address - Street 1:850 HEALTH SCIENCES RD
Practice Address - Street 2:DEPT OF OPHTHALMOLOGY
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92697-4375
Practice Address - Country:US
Practice Address - Phone:949-824-2020
Practice Address - Fax:949-824-4015
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA130598207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology