Etnyre and Mikuni Medical Corporation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G074101 Issued in CA

Legal business name

ETNYRE AND MIKUNI MEDICAL CORPORATION

Practice address

301 S Miller St
Suite 214
Santa Maria, CA 93454-5205

Phone

(805) 349-1202

Fax

(805) 349-0974

NPI assigned

Aug 30, 2005

Organization subpart

No

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

Authorized official

Name

Ms. Diana J. Daugherty

Title

Office Manager

Phone

(805) 349-1202

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ethan Roy Etnyre, MD

  • Family Medicine Physician
  • Oceano, CA
  • NPI 1225021777

  Family Medicine

  NPD (past)
• Karen S Mikuni, MD

  • Family Medicine Physician
  • Oceano, CA
  • NPI 1497748958

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225670400000",
    "number": "1922091487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S MILLER ST",
            "address_2": "SUITE 214",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934545205",
            "telephone_number": "805-349-1202",
            "fax_number": "805-349-0974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S MILLER ST",
            "address_2": "SUITE 214",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934545205",
            "telephone_number": "805-349-1202",
            "fax_number": "805-349-0974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETNYRE AND MIKUNI MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-30",
        "last_updated": "2008-11-03",
        "status": "A",
        "authorized_official_last_name": "DAUGHERTY",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "805-349-1202",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G074101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sonia Nineth Estrada, LMFT
• Wendy Zuleyma Estrada
• Tressa Marie Esty, PA-C
• Sharon Kathleen Etheredge, RD CDE
• Zayna Etheridge
• Natalie Eulloqui, LCSW
• Sergio Eulogio-Angel
• Mallory Evangelista
• Alissa V Evans, AMFT
• Margaret Grace Evans, MS, RDN

• All providers in Santa Maria, CA
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2008; 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.