Basic Information
| Provider Information | |||||||||
| NPI: | 1457668865 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MITTAL | ||||||||
| FirstName: | DISHA | ||||||||
| MiddleName: | KRIPLANI | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | KRIPLANI | ||||||||
| OtherFirstName: | DISHA | ||||||||
| OtherMiddleName: | SHYAM | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 770 THE CITY DR S STE 4000 | ||||||||
| Address2: | |||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928684929 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8004636628 | ||||||||
| FaxNumber: | 7146203008 | ||||||||
| Practice Location | |||||||||
| Address1: | 2825 CAPITOL AVE | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958165615 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9168870000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/07/2010 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 6405 | NE | N | Allopathic & Osteopathic Physicians | Pediatrics | 2080P0203X | A131123 | CA | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Critical Care Medicine | 2080P0203X | 131123 | CA | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Critical Care Medicine |
No ID Information.