Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | AFE12266 | CA |
NPI | 1033497441 |
---|---|
Provider Name | Dr. Robert D Mitchell |
First Address | Loma Linda, CA 92354-3640 |
Second Address | Loma Linda, CA 92354-3640 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2011 |
Last Update Date | 02/08/2011 |