Provider Demographics
NPI:1760647739
Name:CYR, DOUGLAS J
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:J
Last Name:CYR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3521 OCEAN VIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91208-3412
Mailing Address - Country:US
Mailing Address - Phone:818-957-2188
Mailing Address - Fax:
Practice Address - Street 1:3521 OCEAN VIEW BLVD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91208-3412
Practice Address - Country:US
Practice Address - Phone:818-957-2188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-18
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Y00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health Information