Seven O One Medical Clinic, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SEVEN O ONE MEDICAL CLINIC, INC

Practice address

701 N Alvarado St Ste a
Los Angeles, CA 90026-4005

Phone

(213) 302-2472

NPI assigned

Jun 30, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Sidney Todd Mitchell, MD

Title

Ceo/Owner

Phone

(831) 588-2192

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625011200000",
    "number": "1790355899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 N ALVARADO ST STE A",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900264005",
            "telephone_number": "213-302-2472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N ALVARADO ST STE A",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900264005",
            "telephone_number": "213-302-2472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEVEN O ONE MEDICAL CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-30",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "SIDNEY",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "831-588-2192",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "G59020",
            "identifier": "G59020",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, 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 30, 2021; 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.