Individual
CYNTHIA LYNN DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3701 S HIGUERA ST, STE 200, SAN LUIS OBISPO, CA 93401-7462
(805) 541-6033
Mailing address
PO BOX 5007, SAN LUIS OBISPO, CA 93403-5007
(805) 710-7308
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
G50091
CA
207ZP0101X
Anatomic Pathology Physician
G50091
CA
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
G50091
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G500910
—
CA
05
—
GR0058760
—
CA
05
—
LAB43503F
—
CA
Enumeration date
06/26/2006
Last updated
06/21/2024
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