| Pratik D Mehta, MD | |
|
120 Mayfair, Aliso Viejo, CA 92656-2832 | |
| (949) 357-7142 | |
| (209) 468-7042 |
| Full Name | Pratik D Mehta |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 13 Years |
| Location | 120 Mayfair, Aliso Viejo, California |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063853919 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | A139446 (California) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| San Joaquin General Hospital | French camp, CA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| San Joaquin Faculty Medical Group | 4082631395 | 101 |
| County Of San Joaquin | 6002703436 | 161 |
| Entity Name | Faculty Physicians And Surgeons Of Llusm |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205009917 PECOS PAC ID: 1153227814 Enrollment ID: O20031211000981 |
| Entity Name | County Of San Joaquin |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801830583 PECOS PAC ID: 6002703436 Enrollment ID: O20040301001287 |
| Entity Name | Riverside Medical Clinic Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1720183403 PECOS PAC ID: 2961492327 Enrollment ID: O20040517000880 |
| Entity Name | San Joaquin Faculty Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225063761 PECOS PAC ID: 4082631395 Enrollment ID: O20051026000742 |
| Entity Name | Faculty Physicians And Surgeons Of Llusm |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508255175 PECOS PAC ID: 1153227814 Enrollment ID: O20160216002196 |
| Mailing Address | Practice Location Address |
|---|---|
| Pratik D Mehta, MD 120 Mayfair, Aliso Viejo, CA 92656-2832 Ph: (949) 357-7142 | Pratik D Mehta, MD 120 Mayfair, Aliso Viejo, CA 92656-2832 Ph: (949) 357-7142 |