Dr Mark Glenn Mitchell, OD | |
678 E Santa Clara St, San Jose, CA 95112-1931 | |
(408) 293-2020 | |
(408) 271-0225 |
Full Name | Dr Mark Glenn Mitchell |
---|---|
Gender | Male |
Speciality | Optometrist |
Location | 678 E Santa Clara St, San Jose, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1134124308 | NPI | - | NPPES |
SD0082850 | Medicaid | CA | |
P00122561 | Other | NV | RETIRED RAILROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 8285T (California) | Primary |
Provider Name | Mark G Mitchell Od A Professional Corporation |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1962911438 PECOS PAC ID: 8820357197 Enrollment ID: O20180111002235 |
Mailing Address | Practice Location Address |
---|---|
Dr Mark Glenn Mitchell, OD 2425 Golden Hill, Ste 106-205, Paso Robles, CA 93446 Ph: (775) 848-8214 | Dr Mark Glenn Mitchell, OD 678 E Santa Clara St, San Jose, CA 95112-1931 Ph: (408) 293-2020 |
Cyndi C Lee, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1558 S Bascom Ave, San Jose, CA 95125 Phone: 408-371-5180 | |
Christopher Ngo, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1080 S White Rd, A, San Jose, CA 95127 Phone: 408-272-3002 | |
Kari Tran, O.D Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2380 Montpelier Dr, Ste 300, San Jose, CA 95116 Phone: 408-272-3706 Fax: 408-254-4094 | |
Shinmori Optometry Optometrist Medicare: Medicare Enrolled Practice Location: 214 Jackson St, San Jose, CA 95112 Phone: 408-293-3730 Fax: 408-293-2131 | |
Dr. Duc Minh Bui, Optometrist Medicare: Not Enrolled in Medicare Practice Location: 4095 Evergreen Village Sq Ste 110, San Jose, CA 95135 Phone: 408-532-1308 | |
Ms. Cecilia K Imamura, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 55 E Julian St, San Jose, CA 95112 Phone: 408-918-2618 Fax: 408-795-1129 | |
Shirley Quicho, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 590 Blossom Hill Rd, San Jose, CA 95123 Phone: 408-227-2020 Fax: 206-338-0411 |