Provider Demographics
NPI:1518942283
Name:CINK, DAVID EDMUND (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:EDMUND
Last Name:CINK
Suffix:
Gender:M
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 1190
Mailing Address - Street 2:
Mailing Address - City:CRESCENT CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95531-1190
Mailing Address - Country:US
Mailing Address - Phone:707-218-5247
Mailing Address - Fax:707-465-6252
Practice Address - Street 1:1408 E BARNETT RD
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-8279
Practice Address - Country:US
Practice Address - Phone:541-779-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD17064174400000X
CAG53599174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G535990Medicaid
CA00G535990Medicare ID - Type Unspecified
CA00G535990Medicaid