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Individual

MR. BRIAN PAUL MITU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
F.N.P., P.A.-C

Contact information

Practice address
29409 S WESTERN AVE, RANCHO PALOS VERDES, CA 90275-1137
(310) 891-6684
(310) 514-4903
Mailing address
2803 GRAMERCY AVE, TORRANCE, CA 90501-5431
(310) 869-1218

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
18341
CA
363LF0000X
Family Nurse Practitioner
16318
CA
363LP2300X
Primary Care Nurse Practitioner
Primary
16318
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
16318
FNP LICENSE NUMBER
CA
01
18341
PA-C LICENSE NUMBER
CA
Enumeration date
05/30/2006
Last updated
02/25/2024
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