Provider Demographics
NPI:1295956712
Name:FLEMING, CYNTHIA (MD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:
Last Name:FLEMING
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 1:6661 STANFORD RANCH RD # F-347
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95677-2683
Mailing Address - Country:US
Mailing Address - Phone:646-465-2000
Mailing Address - Fax:866-706-4965
Practice Address - Street 1:6661 STANFORD RANCH RD # F-347
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95677-2683
Practice Address - Country:US
Practice Address - Phone:646-465-2000
Practice Address - Fax:866-706-4965
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA521222085R0202X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAF07860Medicare UPIN