Organization Active NPI

Gayle V Mitchell MD Inc

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1174828669
Registry record updated Aug 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A66712 Issued in CA
Legal business name
GAYLE V MITCHELL MD INC
Practice address
1700 E Cesar E Chavez Ave
Suite 1200
Los Angeles, CA 90033-2424
Phone
(310) 486-2369
NPI assigned
Jan 14, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2020

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

Authorized official

Name
Dr. Gayle Vernette Mitchell, MDNPI 1346308228
Title
President/Owner
Phone
(323) 316-9461

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X A66712 CA Primary

Addresses

Primary practice location

1700 E Cesar E Chavez Ave
Suite 1200
Los Angeles, CA 90033-2424

Mailing address

PO Box 2728
Covina, CA 91722-8728

Other identifiers 1

IdentifierTypeStateIssuer
3245917OtherCASECRETARY OF STATE CALIFORNIA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1294963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597276800000",
    "number": "1174828669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2728",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917228728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E CESAR E CHAVEZ AVE",
            "address_2": "SUITE 1200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900332424",
            "telephone_number": "310-486-2369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAYLE V MITCHELL MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-14",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "GAYLE",
        "authorized_official_middle_name": "VERNETTE",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "323-316-9461",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A66712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SECRETARY OF STATE CALIFORNIA",
            "identifier": "3245917",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.