Individual
JERRELL LEE MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
6200 WILSHIRE BLVD STE 1410, LOS ANGELES, CA 90048-5815
(925) 282-1778
Mailing address
6200 WILSHIRE BLVD STE 1410, LOS ANGELES, CA 90048-5815
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
308366
LA
2084P0800X
Psychiatry Physician
2023-02194
NC
2084P0800X
Psychiatry Physician
Primary
20A18705
CA
2084P0800X
Psychiatry Physician
308366
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/08/2016
Last updated
10/15/2024
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