Provider Demographics
NPI:1770662850
Name:FRANCIS, CYNTHIA ANN (PA-C,)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:ANN
Last Name:FRANCIS
Suffix:
Gender:F
Credentials:PA-C,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4529 ALBURY AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90713-2540
Mailing Address - Country:US
Mailing Address - Phone:562-421-0618
Mailing Address - Fax:
Practice Address - Street 1:5953 ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:MAYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90270-3133
Practice Address - Country:US
Practice Address - Phone:323-562-6170
Practice Address - Fax:323-562-6177
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA13476363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA13476OtherSTATE LICENSE FO PA