Victor Mitra

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

51928 Issued in CA

Practice address

454 Forest Ave
Palo Alto, CA 94301-2608

Phone

(650) 331-3700

NPI assigned

Jun 23, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1655942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1295466795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 PARIS ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941123501",
            "telephone_number": "415-624-4171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 FOREST AVE",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943012608",
            "telephone_number": "650-331-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITRA",
        "first_name": "VICTOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-23",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "51928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacquelyn Mitchell, APRN
• Jason Bryan Mitchell, MD
• Linda Frances Mitchell, M.A.
• Megan Lee Mitchell
• Michelle Penney Mitchell, NP
• Shalini Mittal, MD
• Randell Kazuto Miyahara, PHARM.D.
• Matthew Kenji Miyamoto
• Kevin J Mo, PHARMD
• Haleli Moalem

• Physical Therapy Assistant in Palo Alto, CA
• Providers in Palo Alto, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; 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.