Healthcare Provider Details

I. General information

NPI: 1982805479
Provider Name (Legal Business Name): DAVID GEORGE MITCHELL PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 K ST
SACRAMENTO CA
95814-3509
US

IV. Provider business mailing address

505 WESTLAKE DR
W SACRAMENTO CA
95605-2562
US

V. Phone/Fax

Practice location:
  • Phone: 916-444-0690
  • Fax:
Mailing address:
  • Phone: 916-371-1437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number51874
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: