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Individual

JACOB ALLEN MITCHELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CCP

Contact information

Practice address
9888 GENESEE AVE, LA JOLLA, CA 92037-1205
(858) 834-1798
Mailing address
4084 CRYSTAL DAWN LN UNIT 201, SAN DIEGO, CA 92122-5846
(608) 697-9321

Taxonomy

Speciality
Code
Description
License number
State
242T00000X
Perfusionist
Primary

Other

Enumeration date
04/09/2025
Last updated
04/09/2025
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