Individual
STEPHANIE MITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
975 SERENO DR, VALLEJO, CA 94589-2441
(707) 651-1000
Mailing address
975 SERENO DR, VALLEJO, CA 94589-2441
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E5567
CA
Other
Enumeration date
04/05/2016
Last updated
07/22/2019
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