Mid County Surgical Medical Group, Inc.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

G23854 Issued in CA

Legal business name

MID COUNTY SURGICAL MEDICAL GROUP, INC.

Practice address

603 Capitola Ave
Capitola, CA 95010-2751

Phone

(831) 476-5403

Fax

(831) 476-4107

NPI assigned

Jan 8, 2007

Organization subpart

No

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

Authorized official

Name

Dr. John Camara Anane-Sefah, M.D.

Title

President

Phone

(831) 476-5403

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1871641571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 CAPITOLA AVE",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "950102751",
            "telephone_number": "831-476-5403",
            "fax_number": "831-476-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 CAPITOLA AVE",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "950102751",
            "telephone_number": "831-476-5403",
            "fax_number": "831-476-4107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID COUNTY SURGICAL MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "ANANE-SEFAH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "CAMARA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "831-476-5403",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "G23854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0030290",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD JOHN C. ANANE-SEFAH",
            "identifier": "G23854",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Capitola, CA
• Providers in Capitola, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.