1952651762 NPI number — MS. CYNTHIA MCKINNON

Table of content: MS. CYNTHIA MCKINNON (NPI 1952651762)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952651762 NPI number — MS. CYNTHIA MCKINNON

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCKINNON
Provider First Name:
CYNTHIA
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952651762
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/19/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1000 CORPORATE CENTER DR
Provider Second Line Business Mailing Address:
#650
Provider Business Mailing Address City Name:
MONTEREY PARK
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91754-7600
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
323-526-4016
Provider Business Mailing Address Fax Number:
323-526-4096

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9101 WHITTIER BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PICO RIVERA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90660-2405
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-801-4626
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/19/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)