Organization Active NPI

Mitchell D Claire Physician Assistant PC

  • Physician Assistant
  • El Centro, CA
National Provider Identifier
1912756362
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
MITCHELL D CLAIRE PHYSICIAN ASSISTANT PC
Practice address
1073 Ross Ave Ste D
El Centro, CA 92243-4371
Phone
(760) 636-2091
NPI assigned
May 17, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Authorized official

Name
Mitchell D ClaireNPI 1881611317
Title
Owner
Phone
(760) 636-2091

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1073 Ross Ave Ste D
El Centro, CA 92243-4371

Mailing address

14120 Alondra Blvd Ste C
Santa Fe Springs, CA 90670-5842
Phone (562) 407-2080

Other practice location 1

81709 Doctor Carreon Blvd Ste C5
Indio, CA 92201-5577
Phone (760) 636-2091

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240920003128 CA Part B Supplier - Clinic/Group Practice 5294276978 Receives reassigned benefits from 1 practitioner
Practice locations: El Centro, CA; Indio, CA

National Provider Directory

National Provider Directory

Locations

78206 Varner Rd
#D11
Palm Desert, CA 92211

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1715904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721001600000",
    "number": "1912756362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14120 ALONDRA BLVD STE C",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906705842",
            "telephone_number": "562-407-2080",
            "fax_number": "562-407-2082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1073 ROSS AVE STE D",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922434371",
            "telephone_number": "760-636-2091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "81709 Doctor Carreon Blvd Ste C5",
            "address_purpose": "LOCATION",
            "city": "Indio",
            "state": "CA",
            "postal_code": "922015577",
            "country_code": "US",
            "telephone_number": "760-636-2091",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MITCHELL D CLAIRE PHYSICIAN ASSISTANT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-17",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A",
        "authorized_official_last_name": "CLAIRE",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-636-2091"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Centro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.