Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | 204 7301 | CA |
NPI | 1689824849 |
---|---|
Provider Name | Cynthia Lynn Mayer |
First Address | South Pasadena, CA 91031 |
Second Address | Torrance, CA 90503-4698 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2008 |
Last Update Date | 24/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I09519 | (02) | CA |