Siddhartha Mitra, MD, PHD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A115757 Issued in CA

Practice address

1545 Divisadero St
Second Floor
San Francisco, CA 94115-3425

Phone

(415) 353-7900

Fax

(415) 353-2640

NPI assigned

Oct 7, 2009

Last updated

Feb 17, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1254873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297900800000",
    "number": "1235464306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 DIVISADERO ST",
            "address_2": "SECOND FLOOR",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941153425",
            "telephone_number": "415-353-7900",
            "fax_number": "415-353-2640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 DIVISADERO ST",
            "address_2": "SECOND FLOOR",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941153425",
            "telephone_number": "415-353-7900",
            "fax_number": "415-353-2640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITRA",
        "first_name": "SIDDHARTHA",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-07",
        "last_updated": "2011-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A115757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yvette Renee Mitchell
• Beth Avonne Mitchner, PSYD
• Robert J. Mithun, MD
• Selene Louise Mitlyng, PH.D.
• Elliot Jonathan Mitmaker, MD
• John Mitre, MD
• Fumi Mitsuishi, M.D., M.S.
• Pooja C Mittal, DO
• Hisaaki Miura
• Nekissia Nicole Mixon

• Internal Medicine Physician in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2011; 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.