Provider Demographics
NPI:1265568364
Name:BLIFELD, CINDY (MD)
Entity type:Individual
Prefix:DR
First Name:CINDY
Middle Name:
Last Name:BLIFELD
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 1:1111 E OCEAN AVE
Mailing Address - Street 2:STE 6
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436-7076
Mailing Address - Country:US
Mailing Address - Phone:805-736-4970
Mailing Address - Fax:805-736-7592
Practice Address - Street 1:1111 E OCEAN AVE
Practice Address - Street 2:STE 6
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-7076
Practice Address - Country:US
Practice Address - Phone:805-736-4970
Practice Address - Fax:805-736-7592
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA0438422080P0210X
CAA43842208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology