IndividualActive
Jacob Mitchell, CCP
NPI 1306630736 · Perfusionist · La Jolla, CA
Provider details
- NPI number
- 1306630736
- Entity type
- Individual
- Primary specialty
- PerfusionistTechnologists, Technicians & Other Technical Service Providers
- Credential
- CCP
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Technologists, Technicians & Other Technical Service Providers
Practice location
9888 Genesee Ave
La Jolla, CA 92037-1205
Phone: (858) 834-1798
Approximate (ZIP-level) locationGet directions
Mailing address
4084 Crystal Dawn Ln Unit 201
San Diego, CA 92122-5846
Registry dates
- Enumerated
- 2025-04-09
- Last updated
- 2025-04-09
- Certified
- 2025-04-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.