Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | A112409 | CA |
NPI | 1063674620 |
---|---|
Provider Name | Dr. Bryan Andrew Mitton |
First Address | Palo Alto, CA 94303-3341 |
Second Address | Palo Alto, CA 94304-1601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2008 |
Last Update Date | 09/06/2014 |