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1861724189 NPI number — CYNTHIA VALENZUELA MATEO M.D.

NPI Number: 1861724189
Health Care Provider/Practitioner: CYNTHIA VALENZUELA MATEO M.D.

Information about “1861724189” NPI (CYNTHIA VALENZUELA MATEO M.D.) exists in 1861724189 in HTML format HTML  |  1861724189 in plain Text format TXT  |  1861724189 in PDF (Portable Document Format) PDF  |  1861724189 in an XML format XML  formats.

NPI Number : 1861724189 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1861724189",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MATEO",
    "FirstName": "CYNTHIA",
    "MiddleName": "VALENZUELA",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MATEO-WOODBURN",
    "OtherFirstName": "CYNTHIA",
    "OtherMiddleName": "VALENZUELA",
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": null,
    "OtherCredential": "M.D.",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "2209 CENTURY HILL",
    "SecondLineMailingAddress": "149",
    "MailingAddressCityName": "LOS ANGELES",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "90067-3517",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "310-557-0066",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2209 CENTURY HILL",
    "SecondLinePracticeLocationAddress": "149",
    "PracticeLocationAddressCityName": "LOS ANGELES",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "90067-3517",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "310-557-0066",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/11/2010",
    "LastUpdateDate": "02/11/2010",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207L00000X",
        "TaxonomyName": "Anesthesiology Physician",
        "LicenseNumber": "A24537",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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