Provider Demographics
NPI:1558304840
Name:BAILEY, CYNTHIA STEFFENSEN (MD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:STEFFENSEN
Last Name:BAILEY
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 1:7064 CORLINE CT
Mailing Address - Street 2:BLDG C
Mailing Address - City:SEBASTOPOL
Mailing Address - State:CA
Mailing Address - Zip Code:95472-4528
Mailing Address - Country:US
Mailing Address - Phone:707-829-5778
Mailing Address - Fax:707-829-7629
Practice Address - Street 1:7064 CORLINE CT
Practice Address - Street 2:BLDG C
Practice Address - City:SEBASTOPOL
Practice Address - State:CA
Practice Address - Zip Code:95472-4528
Practice Address - Country:US
Practice Address - Phone:707-829-5778
Practice Address - Fax:707-829-7629
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2011-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA43538207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A435381OtherMEDI CAL
CA00A435381OtherMEDI CAL
D04174Medicare UPIN