Provider Demographics
NPI:1699159657
Name:GEIST, CHERI LYNN (PA-C, MPAP)
Entity type:Individual
Prefix:
First Name:CHERI
Middle Name:LYNN
Last Name:GEIST
Suffix:
Gender:F
Credentials:PA-C, MPAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21311 MADRONA AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-5970
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:310-792-4093
Practice Address - Street 1:5525 ETIWANDA AVE STE 224
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-6140
Practice Address - Country:US
Practice Address - Phone:818-344-4803
Practice Address - Fax:818-344-4813
Is Sole Proprietor?:No
Enumeration Date:2015-07-19
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60593874363A00000X
CA52637363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant