Provider Demographics
NPI:1831887702
Name:CYNTHIA L FITZGERALD
Entity type:Organization
Organization Name:CYNTHIA L FITZGERALD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:FITZGERALD
Authorized Official - Suffix:
Authorized Official - Credentials:DACM
Authorized Official - Phone:714-724-9459
Mailing Address - Street 1:20792 MISSION LN
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-6132
Mailing Address - Country:US
Mailing Address - Phone:714-724-9459
Mailing Address - Fax:949-335-4843
Practice Address - Street 1:16831 1/2 ALGONQUIN ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92649-3890
Practice Address - Country:US
Practice Address - Phone:714-846-8120
Practice Address - Fax:949-335-4843
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CYNTHIA L FITZGERALD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty