Courtney Tamiko Mizuhara-Cheng, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A10710 Issued in CA

Practice address

2901 Ocean Park Blvd Ste 207
Santa Monica, CA 90405-2964

Phone

(424) 272-6513

NPI assigned

Jun 29, 2007

Sex

Female

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)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Vdex Medical Group - Cheng

  • Internal Medicine Physician
  • Canoga Park, CA
  • NPI 1174019368
  NPD (past) Authorized official
• St. Isabel Family Medical Clinic, Inc.

  • Primary Care Clinic/Center
  • Harbor City, CA
  • NPI 1700057981
  NPD (past)

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465948800000",
    "number": "1730386145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 OCEAN PARK BLVD STE 207",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904052964",
            "telephone_number": "424-272-6513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 OCEAN PARK BLVD STE 207",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904052964",
            "telephone_number": "424-272-6513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZUHARA-CHENG",
        "first_name": "COURTNEY",
        "middle_name": "TAMIKO",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-29",
        "last_updated": "2016-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A10710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmine Laverne Mitchell, MD
• Natasha Mitra
• Amelia L Mittleman, PA-C
• Miriam Mivehkar, CNM, WHNP
• Janice Kimi Miyakawa, M.D.
• Jenna Anne Mlecko, PT, DPT
• MM Orthopaedics Corporation
• M Ramin Modabber, M.D.
• Jonathan Modai, MD
• Linda Modaro, L.AC.

• Family Medicine Physician in Santa Monica, CA
• Providers in Santa Monica, 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 Jun 15, 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.