Provider Demographics
NPI:1053976878
Name:MEHTA, TRUSHA AMIT (DO)
Entity type:Individual
Prefix:DR
First Name:TRUSHA
Middle Name:AMIT
Last Name:MEHTA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1930 VILLAGE CENTER CIR STE 3-717
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134-6299
Mailing Address - Country:US
Mailing Address - Phone:702-432-2233
Mailing Address - Fax:702-800-5456
Practice Address - Street 1:2020 WELLNESS WAY STE 300
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4145
Practice Address - Country:US
Practice Address - Phone:702-432-2233
Practice Address - Fax:702-800-5456
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-07
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSL14352084N0400X
NVDO33822084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV15889218OtherCAQH ID
NV250025775Medicaid