Healthcare Provider Details

I. General information

NPI: 1588843155
Provider Name (Legal Business Name): CYNTHIA Y. LIDY DBA WE CARE MORE II FAMILY CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2007
Last Update Date: 07/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2110 A N. SANTA FE AVE
COMPTON CA
90222
US

IV. Provider business mailing address

PO BOX 481
LYNWOOD CA
90262-0481
US

V. Phone/Fax

Practice location:
  • Phone: 310-637-7131
  • Fax: 310-637-7172
Mailing address:
  • Phone: 310-637-7131
  • Fax: 310-637-7172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberND9478
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberFNP9478
License Number StateCA

VIII. Authorized Official

Name: MRS. CYNTHIA Y LIDY
Title or Position: OWNER, FNP
Credential: FNP
Phone: 310-637-7131