Mid-County Physicians Ipa

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MID-COUNTY PHYSICIANS IPA

Practice address

4560 Alvarado Canyon Rd
Suite 2a
San Diego, CA 92120-4309

Phone

(619) 684-4976

NPI assigned

May 23, 2007

Organization subpart

No

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

Authorized official

Name

Dan L. Gomez

Title

Director of Provider Services

Phone

(213) 406-2710

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275743494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4560 ALVARADO CANYON RD",
            "address_2": "SUITE 2A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921204309",
            "telephone_number": "619-684-4976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 ALVARADO CANYON RD",
            "address_2": "SUITE 2A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921204309",
            "telephone_number": "619-684-4976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-COUNTY PHYSICIANS IPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "DAN",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "DIRECTOR OF PROVIDER SERVICES",
        "authorized_official_telephone_number": "213-406-2710"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Malia Mickel
• Makaila Rose Mickel
• Kelly Mickler, MS, CCC-SLP
• Emmanuel Jacob Micklus, PSS
• Micronoma Inc.
• Midcounty Surgical Associates LP a California Limited Partnership
• Douglas Malcom Middleton, M.D.
• Michael L Middleton, CRNA
• Michael S Middleton, M.D.
• Payton Midgette

• Family Medicine Physician in San Diego, CA
• Providers in San Diego, 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 Aug 22, 2020; 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.