Provider Demographics
NPI:1689824849
Name:MAYER, CYNTHIA LYNN (DO)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:LYNN
Last Name:MAYER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3065
Mailing Address - Street 2:
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91031
Mailing Address - Country:US
Mailing Address - Phone:602-740-7749
Mailing Address - Fax:
Practice Address - Street 1:4101 TORRANCE BLVD
Practice Address - Street 2:LITTLE COMPANY OF MARY HOSPITAL
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4698
Practice Address - Country:US
Practice Address - Phone:310-303-5764
Practice Address - Fax:310-303-5520
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA204 7301207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI09519Medicare UPIN