Raj a. Mittal, M.D., a Medical Corporation

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

A123128 Issued in CA

Legal business name

RAJ A. MITTAL, M.D., A MEDICAL CORPORATION

Practice address

868 Via del Monte
Palos Verdes Estates, CA 90274-1664

Phone

(310) 483-5411

Fax

(844) 704-5739

NPI assigned

Sep 20, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Raj A Mittal, M.D.NPI 1356541338

Title

President

Phone

(310) 483-5411

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Raj Anand Mittal, M.D.

  • Surgery Physician
  • Torrance, CA
  • NPI 1356541338
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1474329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588032000000",
    "number": "1154879195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "868 VIA DEL MONTE",
            "city": "PALOS VERDES ESTATES",
            "state": "CA",
            "postal_code": "902741664",
            "telephone_number": "310-483-5411",
            "fax_number": "844-704-5739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "868 VIA DEL MONTE",
            "city": "PALOS VERDES ESTATES",
            "state": "CA",
            "postal_code": "902741664",
            "telephone_number": "310-483-5411",
            "fax_number": "844-704-5739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAJ A. MITTAL, M.D., A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-20",
        "last_updated": "2020-04-28",
        "certification_date": "2020-04-28",
        "status": "A",
        "authorized_official_last_name": "MITTAL",
        "authorized_official_first_name": "RAJ",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-483-5411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "A123128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL MEDICARE NPI",
            "identifier": "1356541338",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Michael Schultz, D.D.S.

• Surgery Physician in Palos Verdes Estates, CA
• Providers in Palos Verdes Estates, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.