| NPI | 1609106467 |
|---|---|
| Former Legal Business Name | GARY R MITNICK DO |
| Entity Type | Organization |
| Authorized Contact | GARY ROBERT MITNICK President 805-985-5880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A4379) |
| Enumeration Date | 2009-12-29 |
| Last Update Date | 2010-09-20 |