Individual
MR. THEODORE R MITCHELL IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RDN
Contact information
Practice address
1727 W 51ST PL, LOS ANGELES, CA 90062-2341
(424) 646-0619
Mailing address
1727 W 51ST PL, LOS ANGELES, CA 90062-2341
(424) 646-0619
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
—
—
Other
Enumeration date
05/02/2024
Last updated
05/02/2024
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