Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Gradie B Mixon Jr., MD

Individual provider Anesthesiology Physician · NPI 1164455267

Gradie B Mixon Jr., MD is an Anesthesiology in Modesto, California. Graduated from Loma Linda University School of Medicine in 1980, 46 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
46
Trained at
Loma Linda University School of Medicine
Licensed in
CA
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4601 Dale Rd
Modesto, CA 95356
Phone: (209) 735-5000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence G57069 (CA)

Record details

NPI number1164455267
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJuly 9, 2006
Last updated in NPPESFebruary 11, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyANESTHESIOLOGY
Medical schoolLOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
Graduated 1980 (46 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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