1801988050 NPI number — DR. JANET CYNTHIA CONNEY MD, INC.

Table of content: DR. JANET CYNTHIA CONNEY MD, INC. (NPI 1801988050)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801988050 NPI number — DR. JANET CYNTHIA CONNEY MD, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CONNEY
Provider First Name:
JANET
Provider Middle Name:
CYNTHIA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD, INC.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CONNEY
Provider Other First Name:
JANET
Provider Other Middle Name:
CYNTHIA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD, (SOLE PROPRIETOR
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1801988050
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/19/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12062 VALLEY VIEW STREET
Provider Second Line Business Mailing Address:
SUITE 129
Provider Business Mailing Address City Name:
GARDEN GROVE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92845
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
562-342-3006
Provider Business Mailing Address Fax Number:
562-206-0042

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12062 VALLEY VIEW STREET
Provider Second Line Business Practice Location Address:
SUITE 129
Provider Business Practice Location Address City Name:
GARDEN GROVE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92845
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-342-3006
Provider Business Practice Location Address Fax Number:
562-206-0042
Provider Enumeration Date:
09/28/2006

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: 2084P0805X , with the licence number:  A55794 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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