Provider Demographics
NPI:1568498129
Name:MOYNEUR, CYNTHIA ANNE (RPTMS)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ANNE
Last Name:MOYNEUR
Suffix:
Gender:F
Credentials:RPTMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 CLUB RD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-1410
Mailing Address - Country:US
Mailing Address - Phone:626-825-7801
Mailing Address - Fax:949-222-0890
Practice Address - Street 1:88 CLUB RD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-1410
Practice Address - Country:US
Practice Address - Phone:626-825-7801
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-24
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT0107440225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT10744BMedicare ID - Type UnspecifiedMEDICARE ID