MR. MITCHELL LEE GRESHAM JR.
NPI 1437622883
Counselor - Professional in San Diego, CA
About Mr. Mitchell Lee Gresham Jr. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. MITCHELL LEE GRESHAM JR. (NPI 1437622883) is an individual professional provider in San Diego, California, licensed in California (21573) and active in the NPI registry since January 2019. He is enrolled in Medicare PECOS and is a graduate of Other (2016).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mr. Mitchell Lee Gresham Jr. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAN DIEGO, CA 92154
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mitchell Gresham's NPI number?
The NPI number for Mitchell Gresham is 1437622883. It was assigned to this individual provider in the NPPES registry on January 8, 2019.
Where is Mitchell Gresham located?
Mitchell Gresham practices at 4660 Palm Ave, San Diego, CA 92154. The listed phone number is (183) 357-9484.
What is Mitchell Gresham's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Mitchell Gresham enrolled in Medicare?
Yes. Mitchell Gresham is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Mitchell Gresham was last updated on June 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 51 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mr. Mitchell Lee Gresham Jr. · NPI 1437622883
Professional provider in San Diego, California. Individual provider, active in the CMS NPPES registry since January 8, 2019.
## Identity
- **NPI:** 1437622883 (Entity type: Individual)
- **Enumerated:** January 8, 2019
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** 21573 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 4660 PALM AVE, San Diego, CA 92154-8404
- **Phone:** (183) 357-9484
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Medical school:** Other, class of 2016
## Record status
- **NPPES last updated:** June 19, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1437622883) · Data from the CMS NPPES public registry.