Provider Demographics
NPI:1215201371
Name:AMELON, CYNTHIA RAE (DO)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:RAE
Last Name:AMELON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1333 JONES ST
Mailing Address - Street 2:#602
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109
Mailing Address - Country:US
Mailing Address - Phone:415-922-7742
Mailing Address - Fax:415-922-9955
Practice Address - Street 1:1333 JONES ST #602
Practice Address - Street 2:HOUSE CALLS
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109
Practice Address - Country:US
Practice Address - Phone:415-922-7742
Practice Address - Fax:415-922-9955
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-06
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A5204208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation