Accie Mitchell, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

C28274 Issued in CA

Practice address

19210 S Vermont Ave
BLDG D, Suite 400
Gardena, CA 90248-4426

Phone

(310) 436-0202

Fax

(310) 436-0202

NPI assigned

Aug 2, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Community Family Care Health Plan

  • Health Maintenance Organization
  • Alhambra, CA
  • NPI 1861190449
  NPD (past)

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343001600000",
    "number": "1679580526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19210 S VERMONT AVE",
            "address_2": "BLDG D, SUITE 400",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902484426",
            "telephone_number": "310-436-0202",
            "fax_number": "310-436-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19210 S VERMONT AVE",
            "address_2": "BLDG D, SUITE 400",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902484426",
            "telephone_number": "310-436-0202",
            "fax_number": "310-436-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "ACCIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2012-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "C28274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C282740",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jillian Mikaela Miranda
• Lourdes Ortega Miranda, LCSW
• Regina Lisette Miranda
• Kristin Marie Mischou, M.A.
• Mission Clinic, Inc a California Acupuncture Corpration
• Alison Mitchell
• Amy Mitchell
• M'Sai Mitchell
• Marlon Gerrick Mitchell, B.S.
• Mia Betina Mitchell

• General Practice Physician in Gardena, CA
• Providers in Gardena, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2012; 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.