Provider Demographics
NPI:1588843155
Name:CYNTHIA Y. LIDY DBA WE CARE MORE II FAMILY CLINIC
Entity type:Organization
Organization Name:CYNTHIA Y. LIDY DBA WE CARE MORE II FAMILY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, FNP
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:LIDY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:310-637-7131
Mailing Address - Street 1:PO BOX 481
Mailing Address - Street 2:
Mailing Address - City:LYNWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90262-0481
Mailing Address - Country:US
Mailing Address - Phone:310-637-7131
Mailing Address - Fax:310-637-7172
Practice Address - Street 1:2110 A N. SANTA FE AVE
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90222
Practice Address - Country:US
Practice Address - Phone:310-637-7131
Practice Address - Fax:310-637-7172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND9478363L00000X
CAFNP9478363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGNP000110Medicaid
CA1588843155Medicaid