Provider Demographics
NPI:1447204656
Name:CUMBERLAND, CATHY (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHY
Middle Name:
Last Name:CUMBERLAND
Suffix:
Gender:F
Credentials:MD
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 3699
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92659-8699
Mailing Address - Country:US
Mailing Address - Phone:657-241-3600
Mailing Address - Fax:657-241-7708
Practice Address - Street 1:1190 W BAKER ST
Practice Address - Street 2:STE 100
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-4105
Practice Address - Country:US
Practice Address - Phone:714-668-2500
Practice Address - Fax:714-668-2515
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG47990208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00621282OtherMEDICARE RAILROAD
CAWG47990IMedicare PIN