Provider Demographics
NPI:1659486025
Name:MITZNER, DAVID MICHAEL (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MICHAEL
Last Name:MITZNER
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:27890 CLINTON KEITH RD # D423
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-8571
Mailing Address - Country:US
Mailing Address - Phone:951-506-5768
Mailing Address - Fax:951-296-0090
Practice Address - Street 1:40770 CALIFORNIA OAKS RD STE A
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-5794
Practice Address - Country:US
Practice Address - Phone:951-506-5768
Practice Address - Fax:951-296-0090
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2023-11-17
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Provider Licenses
StateLicense IDTaxonomies
CA20A5898207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF106790Medicare UPIN