Provider Demographics
NPI:1205888922
Name:LOPEZ, MARIA CYNTHIA SINIO (MD)
Entity type:Individual
Prefix:
First Name:MARIA CYNTHIA
Middle Name:SINIO
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5823 YORK BLVD
Mailing Address - Street 2:SUITE #1
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90042-2634
Mailing Address - Country:US
Mailing Address - Phone:323-255-1575
Mailing Address - Fax:323-254-2158
Practice Address - Street 1:5823 YORK BLVD
Practice Address - Street 2:SUITE #1
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90042-2634
Practice Address - Country:US
Practice Address - Phone:323-255-1575
Practice Address - Fax:323-254-2158
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME123184207Q00000X
CAG77794207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015020600Medicaid
FL015020600Medicaid
CAWG77794BMedicare PIN
CA00G777840OtherBLUE SHIELD
CAWG77794AMedicare PIN
CAG28918Medicare UPIN