Active NPI
Gayle V Mitchell, M.D
- Internal Medicine Physician
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- A66712
- Practice address
- 1700 E Cesar E Chavez Ave
Ste 1200
Los Angeles, CA 90033-2424 - Phone
- (323) 523-2216
- NPI assigned
- Dec 4, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A66712 | CA | Primary |
Addresses
Primary practice location
1700 E Cesar E Chavez Ave
Ste 1200
Los Angeles, CA 90033-2424
Mailing address
PO Box 2728
Covina, CA 91722-8728
Phone (323) 316-9461
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A667120 | Medicaid | CA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A66712 | CA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Gayle V Mitchell MD Inc | Internal Medicine | Current | Accepting new patients |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Lewit Worrell MD Inc | Past | Accepting new patients | |
| Marian a. Fedak M.D. Medical Corporation | Past | Accepting new patients |
Locations
1011 Baldwin Park Blvd
Baldwin Park, CA 91706
Phone (626) 851-1011
1700 E Cesar E Chavez Ave
Ste 1200
Los Angeles, CA 90033
Phone (323) 264-7238
1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526
Organizations & group practices 6
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.
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
- Internal Medicine Physician
- Los Angeles, CA
- NPI 1174828669
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
-
dba Target Clinic Medical Associates of Southern California
- Health Maintenance Organization
- Rosemead, CA
- NPI 1942787114
-
dba Foothill ENT Care Specialists
- Otolaryngology/Facial Plastic Surgery Physician
- San Dimas, CA
- NPI 1134317308
-
dba VMV Medical Associates, Inc.
- Specialist
- Los Angeles, CA
- NPI 1619077138
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635897600000",
"number": "1346308228",
"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",
"telephone_number": "323-316-9461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 E CESAR E CHAVEZ AVE",
"address_2": "STE 1200",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900332424",
"telephone_number": "323-523-2216"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "GAYLE",
"middle_name": "V",
"name_prefix": "Dr.",
"credential": "M.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-04",
"last_updated": "2021-11-03",
"certification_date": "2021-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A66712",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A667120",
"state": "CA"
}
],
"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": "1011 Baldwin Park Blvd",
"city": "Baldwin Park",
"state": "CA",
"country_code": "US",
"postal_code": "917065806",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Nov 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.