Individual provider Active NPI

Graham Thomas Mitchell, M.D.

  • Psychiatry Physician
  • Los Angeles, CA
National Provider Identifier
1346419736
Registry record updated Jun 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A106051 Issued in CA
Practice address
3580 Wilshire Blvd
Ste 2000
Los Angeles, CA 90010-2501
Phone
(213) 381-1250
NPI assigned
Feb 29, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A106051 CA Primary

Addresses

Primary practice location

3580 Wilshire Blvd
Ste 2000
Los Angeles, CA 90010-2501

Mailing address

3580 Wilshire Blvd
Ste 2000
Los Angeles, CA 90010-2501
Phone (213) 381-1250

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
I20231020001135 CA Practitioner - Psychiatry 3274989652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
R Franklin University of Med & Sci/Chicago Medical School, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
High Desert Psychological ServicesGroup PAC ID 2860819125, 82 clinicians

Practice addresses (Care Compare)

15497 W Sand St
Victorville, CA 92392-2910
Phone (442) 327-9311

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A106051CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
High Desert Psychological Services CurrentSince Aug 28, 2023 Accepting new patients

Locations

8253 White Oak Ave
Rch Cucamonga, CA 91730
Phone (909) 987-1997

14390 Park Ave
Victorville, CA 92392
Phone (442) 327-9311

15497 W Sand St
Victorville, CA 92392
Phone (442) 327-9311

Organizations & group practices 1

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": "1204243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370390400000",
    "number": "1346419736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3580 WILSHIRE BLVD",
            "address_2": "STE 2000",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900102501",
            "telephone_number": "213-381-1250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 WILSHIRE BLVD",
            "address_2": "STE 2000",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900102501",
            "telephone_number": "213-381-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "GRAHAM",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-29",
        "last_updated": "2013-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A106051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.