Individual provider Active NPI

Mika Ohtomo, M.D.

  • Internal Medicine Physician
  • Monrovia, CA
National Provider Identifier
1124384557
Registry record updated Apr 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A62616 Issued in CA
Practice address
132 Spanner St
Monrovia, CA 91016-4843
Phone
(626) 357-6922
NPI assigned
Apr 10, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A62616 CA Primary
Internal Medicine Physician 207R00000X 16830 MS

Addresses

Primary practice location

132 Spanner St
Monrovia, CA 91016-4843

Mailing address

132 Spanner St
Monrovia, CA 91016-4843

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A62616CAMDInternal Medicine Physician
16830MSMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334016000000",
    "number": "1124384557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 SPANNER ST",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910164843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 SPANNER ST",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910164843",
            "telephone_number": "626-357-6922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OHTOMO",
        "first_name": "MIKA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-10",
        "last_updated": "2012-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A62616",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "16830",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monrovia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.