Organization
CYNTHIA KINGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CNYTHIA KINGERY R.T. (OWNER/PRESIDENT)
(951) 278-5590
Entity
Organization
Contact information
Practice address
31368 FLYING CLOUD DR, LAGUNA NIGUEL, CA 92677-2717
(949) 464-9263
(951) 272-9924
Mailing address
1180 OLYMPIC DR, SUITE 108, CORONA, CA 92881-3393
(951) 278-5590
(951) 272-9924
Taxonomy
Speciality
Code
Description
License number
State
261QR0207X
Mobile Mammography Clinic/Center
Primary
45265
CA
261QR0208X
Mobile Radiology Clinic/Center
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130682
FDA
CA
01
—
45265
DEPT OF HEALTH SERVICES
CA
Enumeration date
01/29/2008
Last updated
09/15/2014
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