Provider Demographics
NPI:1316524952
Name:NINO, CYNTHIA YVETTE
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:YVETTE
Last Name:NINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-5502
Mailing Address - Country:US
Mailing Address - Phone:562-277-9405
Mailing Address - Fax:
Practice Address - Street 1:1900 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-5502
Practice Address - Country:US
Practice Address - Phone:562-277-9405
Practice Address - Fax:562-283-1501
Is Sole Proprietor?:No
Enumeration Date:2021-03-29
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA203820208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics