Courtney Mizuhara-Cheng DO MSHS Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A10710 Issued in CA

Legal business name

COURTNEY MIZUHARA-CHENG DO MSHS INC

Practice address

21201 Victory Blvd Ste 154
Canoga Park, CA 91303-4051

Phone

(818) 661-6367

NPI assigned

Oct 19, 2016

Organization subpart

No

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

Authorized official

Name

Virginia M Newsome, ADMINISTRATOR

Title

Dministrator

Phone

(304) 940-1395

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1476835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476835200000",
    "number": "1205387719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21201 VICTORY BLVD STE 154",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913034051",
            "telephone_number": "818-661-6367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21201 VICTORY BLVD STE 154",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913034051",
            "telephone_number": "818-661-6367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COURTNEY MIZUHARA-CHENG DO MSHS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-19",
        "last_updated": "2016-10-19",
        "status": "A",
        "authorized_official_last_name": "NEWSOME",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DMINISTRATOR",
        "authorized_official_telephone_number": "304-940-1395",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A10710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Canoga Park, CA
• Providers in Canoga Park, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; 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.