Provider Demographics
NPI:1659345551
Name:MITCHELL, DAMON L (ATC)
Entity Type:Individual
Prefix:MR
First Name:DAMON
Middle Name:L
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:4020 MURPHY CANYON RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-4407
Mailing Address - Country:US
Mailing Address - Phone:858-874-4500
Mailing Address - Fax:858-292-4690
Practice Address - Street 1:4020 MURPHY CANYON RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4407
Practice Address - Country:US
Practice Address - Phone:858-874-4500
Practice Address - Fax:858-292-4690
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer