Individual provider Active NPI

Andrew Gregory Mitton, M.D.

  • Vascular Neurology Physician
  • Malibu, CA
National Provider Identifier
1063707297
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Neurology PhysicianTaxonomy code 2084V0102X
License
A130524 Issued in CA
Practice address
23815 Stuart Ranch Rd Ste 300
Malibu, CA 90265-4861
Phone
(310) 456-1668
NPI assigned
Jun 15, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Neurology Physician 2084V0102X A130524 CA Primary

Addresses

Primary practice location

23815 Stuart Ranch Rd Ste 300
Malibu, CA 90265-4861

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Phone (310) 301-8707

Other practice location 1

9449 Imperial Hwy
Downey, CA 90242-2814
Phone (562) 807-6200

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170328002931 CA Practitioner - PsychiatryPractitioner - Addiction Medicine 6507141850 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Addiction Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

6041 Cadillac Ave
Los Angeles, CA 90034-1702
Phone (800) 954-8000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A130524CAMDVascular Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 21, 2025 Accepting new patients

Locations

9333 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-3340

6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000

4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784

4867 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 783-7920

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1308096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1063707297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-301-8707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23815 STUART RANCH RD STE 300",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902654861",
            "telephone_number": "310-456-1668"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9449 Imperial Hwy",
            "address_purpose": "LOCATION",
            "city": "Downey",
            "state": "CA",
            "postal_code": "902422814",
            "country_code": "US",
            "telephone_number": "562-807-6200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITTON",
        "first_name": "ANDREW",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-15",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "CA",
            "license": "A130524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "6041 Cadillac Ave",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900341702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Malibu, CA

Sources for this page

Verify at the official NPI Registry.