Healthcare Provider Details

I. General information

NPI: 1609011196
Provider Name (Legal Business Name): CINDY THOMAS CFM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2008
Last Update Date: 12/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1705 COFFEE RD SUITE 3
MODESTO CA
95355-2809
US

IV. Provider business mailing address

693 HI TECH PKWY
OAKDALE CA
95361-9113
US

V. Phone/Fax

Practice location:
  • Phone: 209-550-0100
  • Fax: 209-550-0117
Mailing address:
  • Phone: 209-845-8231
  • Fax: 209-845-2883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License NumberCFM00776
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: