Individual provider · Type 1 NPI

Mia Jade Pattillo, MD

Student in an Organized Health Care Education/Training Program · Los Angeles, CA

NPI number 1669266995 Active

Practice location

757 Westwood Plz
Los Angeles, CA 90095-8358

Call (404) 428-3092 Map

Mailing address

572 Lincoln Pl Apt 3A
Brooklyn, NY 11216-4192

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000X390200000X (NY)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1669266995

Mia Jade Pattillo, MD's National Provider Identifier is 1669266995, issued on Apr 9, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Los Angeles, CA. The record was last updated on Apr 9, 2025.