Provider Demographics
NPI:1598705485
Name:MITCHELL, JAMES F JR (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:F
Last Name:MITCHELL
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10040
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92685-0040
Mailing Address - Country:US
Mailing Address - Phone:800-358-8179
Mailing Address - Fax:
Practice Address - Street 1:2705 LOMA VISTA RD STE 205
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-1582
Practice Address - Country:US
Practice Address - Phone:805-585-3086
Practice Address - Fax:805-653-0161
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG46712207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G467120Medicaid
CAWG46712VMedicare PIN
CAWG46712UMedicare PIN
A50469Medicare UPIN