Most Relevant Information
Provider Data
| NPI Number: | 1003490921 |
| Provider Name: | MAITRI MEHTA DO |
| Entity Type: | Individual |
| Taxonomy Code: | 207Q00000X |
| Specialty: | Family Medicine |
| License Number: | 125-078487 |
Most Important Dates
| Enumeration Date: | 05/06/2021 |
| Last Updated: | 06/13/2022 |
Provider Practice Location
102 S HENNEPIN AVE
DIXON
IL
610213013
Practice Location Phone/Fax
| Phone: | 8152858520 |
| Fax: | 8152858903 |
Provider Mailing Location
1038 GARDENWOOD DR
SAN JOSE
CA
951293017
Provider Mailing Phone/Fax
| Phone: | 4086368636 |
| Fax: |
Suggested EMR
Family Practice EMR