DR. KETAN C MEHTA (NPI# 1942331608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942331608 |
| Entity Type | Individual |
| Full Name | DR. KETAN C MEHTA |
| Credential | M.D. |
| Practice Address |
3867 Montgomery Dr Santa Rosa CA 95405-5244 |
| Practice Telephone | 7075253780 |
| Practice Fax Number | 7075253783 |
| Mailing Telephone | 7075253780 |
| Mailing Fax Number | 7075253783 |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2011-01-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | A41306 | CA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00A413060 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144298316 | Ketan C Mehta | Pediatrics | 4123 Dutchmans Ln Ste 301, Louisville, KY 40207-4721 | 2006-03-14 |
| 1992293849 | Ketan Mehta | Student in an Organized Health Care Education/Training Program | 2001 W 68th St Ste 202, Hialeah, FL 33016-1898 | 2018-04-26 |
| 1184124687 | Ketan Mehta | General Practice | 9040a Jackson Ave, Joint Base Lewis Mcchord, WA 98431-0001 | 2018-02-20 |
| Street Address |
3867 MONTGOMERY DR |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95405-5244 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548298060 | James Marco Steele | Internal Medicine | 3867 Montgomery Dr, Santa Rosa, CA 95405-5244 | 2006-06-30 |
| 1952603177 | Northern California Medical Assoc Inc | Internal Medicine | 3867 Montgomery Dr, Santa Rosa, CA 95405-5244 | 2010-11-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083230486 | Lizett Camacho | Counselor | 145o Neotomas Avenue Suite 200, Santa Rosa, CA 95405 | 2020-06-22 |
| 1346768918 | Ingrid Tsong | Student in an Organized Health Care Education/Training Program | 3447 Summerfield Road, Santa Rosa, CA 95405 | 2017-09-05 |
| 1275051898 | Jessica Peters Malmberg | Student in an Organized Health Care Education/Training Program | 2447 Summerfield Rd, Santa Rosa, CA 95405 | 2017-09-04 |
| 1306246772 | Kirsten Eckert | Advanced Practice Midwife | 500 Doyle Park Dr Suite 103, Santa Rosa, CA 95405 | 2014-09-03 |
| 1982034294 | Mohammad Reza Saeidi | Dentist | 1820 Sonoma Ave Ste 90a, Santa Rosa, CA 95405 | 2013-11-22 |
| 1851631642 | Debi M. Emmons | Marriage & Family Therapist | 2447 Summerfield Dr, Social Advocates for Youth, Santa Rosa, CA 95405 | 2013-02-15 |
| 1841549979 | Karie Louise Klim | Marriage & Family Therapist | 182 Farmers Ln Ste 204, Santa Rosa, CA 95405 | 2012-09-05 |
| 1427314400 | Rachel E. Page | Counselor | 2447 Summerfield Rd., Santa Rosa, CA 95405 | 2012-04-04 |
| 1689991572 | Center for Integral Healing Inc. | Community Health Worker | 182 Farmers Lane, #203, Santa Rosa, CA 95405 | 2010-04-30 |
| 1588997647 | Kai Morgan | Dentist | 1144 Suite 116 Soonoma Ave, Santa Rosa, CA 95405 | 2009-09-08 |
| Find all providers in zip 95405 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558897538 | Maya's Massage Inc. | Specialist | 1955 Dogwood Dr, Santa Rosa, CA 95403-1577 | 2017-05-11 |
| 1972053114 | Peter John Holewinski | Specialist | 170 Farmers Ln Ste 11, Santa Rosa, CA 95405-4750 | 2016-10-12 |
| 1922425123 | Kellie Ann Hislop | Specialist | 320 Tesconi Circle, Suite G, Santa Rosa, CA 95401 | 2014-03-25 |
| 1841460698 | Julie Hindley | Specialist | 6574 Oakmont Drive, Santa Rosa, CA 95409 | 2008-03-07 |
| 1659553436 | David Moll | Specialist | 85 Brookwood Ave, Suite 22, Santa Rosa, CA 95404-4513 | 2007-12-03 |
| 1952591620 | Juliana Margarita Ribar | Specialist | 211 Ridgeway Ave., Santa Rosa, CA 95401 | 2007-07-30 |
| 1831302090 | Chris Everett Kerger | Specialist | 3855 Princeton Dr, Santa Rosa, CA 95405-7061 | 2007-05-07 |
| 1598977498 | Santa Rosa Cardiac Surgery | Specialist | 3536 Mendocino Ave., Suite 250, Santa Rosa, CA 95403 | 2007-05-04 |
| 1417086281 | John Martin Mcavoy | Specialist | 4773 Hoen Ave, Santa Rosa, CA 95405-7862 | 2007-03-05 |
| 1629103205 | David P Suchard IIi | Specialist | 1260 N Dutton Ave Ste 244, Santa Rosa, CA 95401-4672 | 2007-02-22 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95405 |
Please comment or provide details below to improve the information on DR. KETAN C MEHTA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.