| Doctor Name: | PROMILLA MEHRA |
| NPI Number: | 1235169277 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 23774 |
| Business Practice Address: | 4485 Wadsworth Blvd Suite 205 Wheatridge, CO - 80033 |
| Business Phone Number: | 3034246950 |
| Business Fax Number: | 3034247935 |
| Mailing Address: | 4485 Wadsworth Blvd, Suite 205 WHEATRIDGE |
| State: | CO |
| Postal Code: | 80033 |
| Phone Number: | 3034246950 |
| Fax Number: | 3034247935 |
| NPI Enumeration Date: | 07/04/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 23774 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |