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General NPI Number Information
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NPI Number | 1285988410
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Entity Type | Organization
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Legal Business Name | MITCHELL C AUSTIN MD INC
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Dates
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Enumeration Date | 11/09/2012
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Last Update Date | 11/09/2012
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Provider Practice Location Address
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Address Line | 1441 AVOCADO AVE #701
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-7708
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Country | US
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Telephone | 949-644-1881
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Fax | 949-644-4918
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Provider Business Mailing Address
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Address Line | 1441 AVOCADO AVE #701
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-7708
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Country | US
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Telephone | 949-644-1881
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Fax | 949-644-4918
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Authorized Official
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Title or Position | CEO
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Name | DR. MITCHELL CLYDE AUSTIN
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Credential | MD
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Telephone | 949-644-1881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | C36529
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License Number State | CA
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