Wendy G Mitchell, M.D.

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

License

A91072 Issued in CA

Practice address

4650 Sunset Blvd.
Ms# 82
Los Angeles, CA 90027-6062

Phone

(323) 669-2471

Fax

(323) 361-1109

NPI assigned

Oct 25, 2006

Sex

Female

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Children's Hospital Los Angeles Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • Los Angeles, CA
  • NPI 1265530653
  Medicare reassignment NPD
• Children's Hospital Los Angeles

  • Children's Chronic Disease Hospital
  • Los Angeles, CA
  • NPI 1366527954
  NPD (past)
• Childrens Hospital of Los Angeles

  • Children's Hospital
  • Los Angeles, CA
  • NPI 1124073366
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352851200000",
    "number": "1699859652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6430 SUNSET BLVD.",
            "address_2": "SUITE 600",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900287900",
            "telephone_number": "323-361-2337",
            "fax_number": "323-361-8491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 SUNSET BLVD.",
            "address_2": "MS# 82",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "323-669-2471",
            "fax_number": "323-361-1109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "WENDY",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2012-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "CA",
            "license": "A91072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G277250",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Theodore R Mitchell IV, RDN
• Tiffany Mitchell, M.D.
• Tracy Angelique Mitchell
• Trinice Sarah Mitchell
• Tristan Mitchell, BA
• Yolanda Mitchell
• Ashley Mitchen, PA-C
• Mitchlock Foundation
• Natasha Mitchnick, PPS
• Patricia Mitha, LMFT

• Neurology with Special Qualifications in Child Neurology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Neurology with Special Qualifications in Child Neurology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2012; 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.

Verify at the official NPI Registry.