Individual ProviderJeffrey Alan MitchellPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address9350 Campus Point Dr, La Jolla, CA 92037(858) 657-6879PECOS EnrollmentBased on the most recent information from CMS, provider Jeffrey Alan Mitchell does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1497827638Provider TypeIndividualFull NameMitchell, Jeffrey AlanCredentialP.T.GenderMaleSole ProprietorNoEnumeration Date11/14/2006Last Updated8/10/2018Contact InformationPractice LocationPractice Address9350 Campus Point Dr, La Jolla, CA 92037Phone(858) 657-6879Fax(858) 657-6873Mailing LocationMailing AddressPO Box 232410, San Diego, CA 92193-2410PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicensePT37484CaliforniaProvider IdentifiersIDDescriptionIssuerIDCB5773DescriptionOtherIssuerRR MEDICARE GROUPID37903705DescriptionOtherIssuerMEDICAID LAB GROUPKentuckyID650025334DescriptionOtherIssuerRR MEDICARE PINID4000501DescriptionOtherIssuerMEDICARE LAB GROUPKentucky