Provider Demographics
NPI:1942623947
Name:CANTIN, DENISE DORIS (DO)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:DORIS
Last Name:CANTIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21721 CLYDESDALE CIR
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-1442
Mailing Address - Country:US
Mailing Address - Phone:909-595-3245
Mailing Address - Fax:
Practice Address - Street 1:13514 POMERADO RD
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-3551
Practice Address - Country:US
Practice Address - Phone:760-213-5022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-27
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A6247208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice