Provider Demographics
NPI:1083767636
Name:THOMAS, CYNTHIA LYNN (DO)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:LYNN
Last Name:THOMAS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:16017 TUSCOLA RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-1317
Mailing Address - Country:US
Mailing Address - Phone:760-946-1776
Mailing Address - Fax:760-946-1668
Practice Address - Street 1:16017 TUSCOLA RD
Practice Address - Street 2:SUITE E
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-1317
Practice Address - Country:US
Practice Address - Phone:760-946-1776
Practice Address - Fax:760-946-1668
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A6876207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX68760OtherMEDI-CAL
CA020A68760Medicare ID - Type Unspecified
CAH34742Medicare UPIN