Organization Active NPI

Cynthia a. Cork, M.D., Inc.

  • Obstetrics & Gynecology Physician
  • Fountain Valley, CA
National Provider Identifier
1023266897
Registry record updated Mar 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
G53015 Issued in CA
Legal business name
CYNTHIA A. CORK, M.D., INC.
Practice address
11180 Warner Ave
Suite 455
Fountain Valley, CA 92708-7501
Phone
(714) 556-0536
Fax
(714) 435-9640
NPI assigned
Sep 4, 2008
Last updated
Mar 14, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Cynthia Arlene Cork, M.D.NPI 1134229602
Title
President
Phone
(714) 556-0536

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X G53015 CA Primary

Addresses

Primary practice location

11180 Warner Ave
Suite 455
Fountain Valley, CA 92708-7501

Mailing address

11180 Warner Ave
Suite 455
Fountain Valley, CA 92708-7501
Phone (714) 556-0536

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211208002915 CA Part B Supplier - Clinic/Group Practice 5991195893 Receives reassigned benefits from 1 practitioner
Practice locations: Fountain Valley, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1220486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363219200000",
    "number": "1023266897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11180 WARNER AVE",
            "address_2": "SUITE 455",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087501",
            "telephone_number": "714-556-0536",
            "fax_number": "714-435-9640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11180 WARNER AVE",
            "address_2": "SUITE 455",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087501",
            "telephone_number": "714-556-0536",
            "fax_number": "714-435-9640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CYNTHIA A. CORK, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-04",
        "last_updated": "2013-03-14",
        "status": "A",
        "authorized_official_last_name": "CORK",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "ARLENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-556-0536",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G53015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.