Individual
STEVEN MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DRIVER
Contact information
Practice address
4889 STREAMBAY CT, RIVERSIDE, CA 92505-5130
(951) 230-9156
Mailing address
4889 STREAMBAY CT, RIVERSIDE, CA 92505-5130
(951) 230-9156
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
46-5613115
—
CA
Enumeration date
10/28/2021
Last updated
10/29/2021
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