Individual
STEVEN A MITNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2455 SUMMERFIELD RD, SANTA ROSA, CA 95405-7815
(707) 308-2815
Mailing address
325 DISTEL CIR, LOS ALTOS, CA 94022-1408
(707) 523-7141
(707) 523-7245
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
G51282
CA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
G51282
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G512820
—
CA
Enumeration date
07/13/2006
Last updated
04/29/2021
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