Provider Demographics
NPI:1285880278
Name:PADILLA, CYNTHIA SANTOS-OCAMPO (MD)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:SANTOS-OCAMPO
Last Name:PADILLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:DIZON
Other - Last Name:SANTOS-OCAMPO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 6010
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59406-6010
Mailing Address - Country:US
Mailing Address - Phone:406-455-4470
Mailing Address - Fax:406-455-4470
Practice Address - Street 1:1101 26TH ST S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-5161
Practice Address - Country:US
Practice Address - Phone:406-455-5315
Practice Address - Fax:406-455-4988
Is Sole Proprietor?:No
Enumeration Date:2008-08-11
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT115232080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000093948OtherBCBS
MT000093948OtherBCBS
MT011002583Medicare PIN