Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | G60992 | CA |
NPI | 1912061581 |
---|---|
Provider Name | Dr. Cynthia Murphy |
First Address | Seal Beach, CA 90740-8157 |
Second Address | Tustin, CA 92780-2925 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2006 |
Last Update Date | 03/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G60992 | PTAN (01) | CA |