Provider Demographics
NPI:1922050566
Name:MIMBS, JEFFREY SCOTT (DO)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:SCOTT
Last Name:MIMBS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:251 COHASSET RD
Mailing Address - Street 2:SUITE 370
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-2241
Mailing Address - Country:US
Mailing Address - Phone:530-895-3333
Mailing Address - Fax:530-895-3217
Practice Address - Street 1:251 COHASSET RD
Practice Address - Street 2:SUITE 370
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2241
Practice Address - Country:US
Practice Address - Phone:530-895-3333
Practice Address - Fax:530-895-3217
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2014-02-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA20A6783207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA140008076OtherRR MEDICARE
CA00AX67830Medicaid
CA020A67830Medicare PIN
CA140008076OtherRR MEDICARE