Provider Demographics
NPI:1861724189
Name:MATEO, CYNTHIA VALENZUELA (MD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:VALENZUELA
Last Name:MATEO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CYNTHIA
Other - Middle Name:VALENZUELA
Other - Last Name:MATEO-WOODBURN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2209 CENTURY HILL
Mailing Address - Street 2:149
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90067-3517
Mailing Address - Country:US
Mailing Address - Phone:310-557-0066
Mailing Address - Fax:
Practice Address - Street 1:2209 CENTURY HILL
Practice Address - Street 2:149
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90067-3517
Practice Address - Country:US
Practice Address - Phone:310-557-0066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA24537207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology