Provider Demographics
NPI:1376593699
Name:MARCON, CINDY (RPT)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:MARCON
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:PO BOX 1587
Mailing Address - Street 2:
Mailing Address - City:VALLEY CENTER
Mailing Address - State:CA
Mailing Address - Zip Code:92082-1587
Mailing Address - Country:US
Mailing Address - Phone:760-207-0632
Mailing Address - Fax:760-888-9234
Practice Address - Street 1:13445 HILLDALE RD
Practice Address - Street 2:
Practice Address - City:VALLEY CENTER
Practice Address - State:CA
Practice Address - Zip Code:92082-3418
Practice Address - Country:US
Practice Address - Phone:760-207-0632
Practice Address - Fax:760-888-9234
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22510000X225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT1445Medicare ID - Type UnspecifiedRPT