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General NPI Number Information
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NPI Number | 1417747049
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Entity Type | Individual
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Provider Name | PAMELA MITCHELL MPT
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Gender | Female
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Dates
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Enumeration Date | 05/07/2025
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 1840 WEST DR
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City | VISTA
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State | CA
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Zip | 92083-6115
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Country | US
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Telephone | 619-205-4585
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Fax |
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Provider Business Mailing Address
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Address Line | 910 NIGUEL ST
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City | OCEANSIDE
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State | CA
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Zip | 92057-2638
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Country | US
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Telephone | 916-544-2444
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 36657
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License Number State | CA
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