Provider Demographics
NPI:1336378231
Name:G. M. MITTS, M. D. INC
Entity Type:Organization
Organization Name:G. M. MITTS, M. D. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:MURRAY
Authorized Official - Last Name:MITTS
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:661-324-3403
Mailing Address - Street 1:2525 H ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-2817
Mailing Address - Country:US
Mailing Address - Phone:661-324-7208
Mailing Address - Fax:661-324-3403
Practice Address - Street 1:2525 H ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-2817
Practice Address - Country:US
Practice Address - Phone:661-324-7208
Practice Address - Fax:661-324-3403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-13
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG35729208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty