Provider Demographics
NPI:1770517245
Name:HERRINGTON, CYNTHIA SUE (MD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:SUE
Last Name:HERRINGTON
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:P.O. BOX 31309
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-0309
Mailing Address - Country:US
Mailing Address - Phone:323-442-5849
Mailing Address - Fax:
Practice Address - Street 1:4650 W SUNSET BLVD
Practice Address - Street 2:MS # 66
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6062
Practice Address - Country:US
Practice Address - Phone:323-442-6793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2017-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN37990208600000X, 208G00000X
CAG84606208600000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNH00463Medicare UPIN
CAAP503YMedicare PIN
CA00G846060OtherBLUE SHIELD PROVIDER NUMBER
MN20G85HEOtherBCBS
MNH00463Medicare UPIN
CAAP503YMedicare PIN
MN126905OtherUCARE
MN300761800Medicaid
MN1020143OtherPREFERRED ONE
MN18-07074OtherMEDICA CHOICE & PRIMARY
MN846396OtherARAZ