Doctor Name: | BRIAN THOMAS MITCHELL |
NPI Number: | 1639451149 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.O. |
License Number: | 2OA11937 |
Business Practice Address: | 201 Arch St Redwood City, CA - 940621305 |
Business Phone Number: | 6505569420 |
Business Fax Number: | 6505689053 |
Mailing Address: | 201 Arch St, REDWOOD CITY |
State: | CA |
Postal Code: | 940621305 |
Phone Number: | 6505569420 |
Fax Number: | 6505689053 |
NPI Enumeration Date: | 09/12/2011 |
NPI Last Update Date: | 03/01/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 2OA11937 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |