Provider Demographics
NPI:1114946126
Name:THOMAS, CINDY LOUISE (RPT)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:LOUISE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20192 BAYVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-0707
Mailing Address - Country:US
Mailing Address - Phone:714-963-8855
Mailing Address - Fax:714-963-5775
Practice Address - Street 1:20192 BAYVIEW AVE
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660
Practice Address - Country:US
Practice Address - Phone:949-295-7325
Practice Address - Fax:949-295-7325
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT11954225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT11954DMedicare PIN