Provider Demographics
NPI:1053726133
Name:MEHTA, TORAL TRIVEDI (MD)
Entity type:Individual
Prefix:
First Name:TORAL
Middle Name:TRIVEDI
Last Name:MEHTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TORAL
Other - Middle Name:BHARAT
Other - Last Name:TRIVEDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:818 MAGNOLIA AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-3128
Mailing Address - Country:US
Mailing Address - Phone:951-352-3577
Mailing Address - Fax:
Practice Address - Street 1:818 MAGNOLIA AVE STE 102
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-3128
Practice Address - Country:US
Practice Address - Phone:951-352-3577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-26
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA154117207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty