Individual
CYNTHIA LYNN DETATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
00A611180
CA
207V00000X
Obstetrics & Gynecology Physician
A61118
CA
207VX0000X
Obstetrics Physician
Primary
A61118
CA
Other
Enumeration date
11/01/2006
Last updated
04/24/2024
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