Organization Active NPI

Mina Sehhat MD PC

  • Primary Care Clinic/Center
  • San Jose, CA
National Provider Identifier
1104101898
Registry record updated Oct 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
A63182 Issued in CA
Legal business name
MINA SEHHAT MD PC
Practice address
2101 Forest Ave
Suite # 104
San Jose, CA 95128-1448
Phone
(408) 975-7680
NPI assigned
Oct 13, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2011

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

Authorized official

Name
Dr. Mina Sehhat, M.D.NPI 1558393314
Title
Ceo
Phone
(408) 975-7680

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X A63182 CA Primary

Addresses

Primary practice location

2101 Forest Ave
Suite # 104
San Jose, CA 95128-1448

Mailing address

2101 Forest Ave
Suite # 104
San Jose, CA 95128-1448
Phone (408) 975-7680

Other identifiers 1

IdentifierTypeStateIssuer
00A631820MedicaidCA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1058034Mina Sehhat MD2101 Forest Avenue, Suite 104, San Jose, CA 95128Certificate of waiverAug 27, 2026

National Provider Directory

National Provider Directory

Locations

2101 Forest Ave
Ste 104
San Jose, CA 95128
Phone (408) 975-7680

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1318464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318464000000",
    "number": "1104101898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 FOREST AVE",
            "address_2": "SUITE # 104",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281448",
            "telephone_number": "408-975-7680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 FOREST AVE",
            "address_2": "SUITE # 104",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281448",
            "telephone_number": "408-975-7680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINA SEHHAT MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-13",
        "last_updated": "2011-10-13",
        "status": "A",
        "authorized_official_last_name": "SEHHAT",
        "authorized_official_first_name": "MINA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "408-975-7680",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "A63182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A631820",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.