MEDICARE: MACKENZIE MAY CYPHER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	95007594	CA

General Provider Information

NPI Number	:	1114432101
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MACKENZIE MAY CYPHER

Provider Business Mailing Address
First Line	:	6155 CORNERSTONE CT E STE 220
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-4737
Country	:	US
Telephone Number	:	858-458-2992
Fax Number	:	858-458-3655

Provider Business Practice Location Address
First Line	:	6155 CORNERSTONE CT E STE 220
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-4737
Country	:	US
Telephone Number	:	858-458-2992
Fax Number	:	858-458-3655

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2017
Last Update Date	:	12/12/2017

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Directions to “ MACKENZIE MAY CYPHER ” Practice Location

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