Provider Demographics
NPI:1801579420
Name:AN, CINDY SIEUN (AGPCNP-BC)
Entity type:Individual
Prefix:MISS
First Name:CINDY
Middle Name:SIEUN
Last Name:AN
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:224 N FAIR OAKS AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91103-3618
Mailing Address - Country:US
Mailing Address - Phone:626-696-1400
Mailing Address - Fax:626-696-1451
Practice Address - Street 1:100 N STATE COLLEGE BLVD STE H
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92831-4236
Practice Address - Country:US
Practice Address - Phone:714-824-6565
Practice Address - Fax:714-930-7926
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-10
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA95025982363L00000X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner