Provider Demographics
NPI:1467531392
Name:MITCHELL, CLINTON AARON (PA-C)
Entity Type:Individual
Prefix:MR
First Name:CLINTON
Middle Name:AARON
Last Name:MITCHELL
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:PHR GROUP PE UNIT 3RD FLOOR
Mailing Address - Street 2:393 E WALNT STREET
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91188-0001
Mailing Address - Country:US
Mailing Address - Phone:626-405-7914
Mailing Address - Fax:877-514-0903
Practice Address - Street 1:1505 WILSON TER
Practice Address - Street 2:SUITE 200
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-4071
Practice Address - Country:US
Practice Address - Phone:818-246-8974
Practice Address - Fax:818-246-7673
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2021-11-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPA 18069363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical