Individual provider Active NPI

Mianda Cheree Carr, MD

  • Obstetrics & Gynecology Physician
  • National City, CA
National Provider Identifier
1083815823
Registry record updated Apr 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A104660 Issued in CA
Practice address
2400 E 8TH St
National City, CA 91950-2956
Phone
(619) 662-4118
NPI assigned
May 30, 2007
Last updated
Apr 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A104660 CA Primary

Addresses

Primary practice location

2400 E 8TH St
National City, CA 91950-2956

Mailing address

4004 Beyer Blvd
San Ysidro, CA 92173-2007
Phone (619) 662-4123

Other practice location 1

195 Page Mill Rd Ste 103
Palo Alto, CA 94306-2073
Phone (888) 731-8994

Other names 1

  • Mianda Cheree Carr Cook Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081006000174 CA Practitioner - Obstetrics/Gynecology 4486722378 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
104660CAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Salud de la Comunidad de San Ysidro, Inc. Current Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. CurrentSince Sep 3, 2019 Accepting new patients
Obhg California, P.C. Obstetrics & Gynecology CurrentSince Sep 4, 2019 Accepting new patients
Emergency and Acute Care Medical Corporation CurrentSince Oct 27, 2016 Accepting new patients
Scripps Health Current Accepting new patients
Sutter Gould Medical Foundation Past Accepting new patients

Locations

1637 Third Ave
Ste B
Chula Vista, CA 91911
Phone (619) 425-1780

1136 D Ave
National City, CA 91950
Phone (619) 336-2300

39000 Bob Hope Dr
Rancho Mirage, CA 92270
Phone (760) 340-3911

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

1601 Precision Park Ln
San Ysidro, CA 92173
Phone (619) 205-4585

4004 Beyer Blvd
San Ysidro, CA 92173
Phone (619) 428-1330

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mcarr182324@direct.llu.edu
  • Direct secure messaging: mcarr18674@syhealth.direct-ci.com
  • Direct secure messaging: mcarr80865@scrippshlth.medalliesdirect.net
  • Direct secure messaging: mianda.carr@335000925634564.direct.elationemr.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776384000000",
    "number": "1083815823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4004 BEYER BLVD",
            "city": "SAN YSIDRO",
            "state": "CA",
            "postal_code": "921732007",
            "telephone_number": "619-662-4123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 E 8TH ST",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502956",
            "telephone_number": "619-662-4118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "195 Page Mill Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Palo Alto",
            "state": "CA",
            "postal_code": "943062073",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARR",
        "first_name": "MIANDA",
        "middle_name": "CHEREE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-30",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A104660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIANDA",
            "last_name": "CARR COOK",
            "middle_name": "CHEREE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in National City, CA

Sources for this page

Verify at the official NPI Registry.