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General NPI Number Information
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NPI Number | 1174828669
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Entity Type | Organization
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Legal Business Name | GAYLE V MITCHELL MD INC
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Dates
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Enumeration Date | 01/14/2011
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Last Update Date | 08/13/2020
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Provider Practice Location Address
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Address Line | 1700 E CESAR E CHAVEZ AVE SUITE 1200
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City | LOS ANGELES
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State | CA
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Zip | 90033-2424
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Country | US
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Telephone | 310-486-2369
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2728
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City | COVINA
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State | CA
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Zip | 91722-8728
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. GAYLE VERNETTE MITCHELL
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Credential | MD
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Telephone | 323-316-9461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A66712
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License Number State | CA
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