Healthcare Provider Details

I. General information

NPI: 1932382512
Provider Name (Legal Business Name): CYNTHIA J. PRICE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2007
Last Update Date: 09/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2777 E CAMELBACK RD STE 140
PHOENIX AZ
85016
US

IV. Provider business mailing address

2777 E CAMELBACK RD STE 140
PHOENIX AZ
85016-4351
US

V. Phone/Fax

Practice location:
  • Phone: 480-946-7939
  • Fax: 480-946-5258
Mailing address:
  • Phone: 480-946-7939
  • Fax: 480-946-5258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA94594
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number44247
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: