Individual provider Active NPI

Cynthia Villacorta Lavadia, M.D.

  • Specialist
  • Fullerton, CA
National Provider Identifier
1659302230
Registry record updated Mar 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A45839 Issued in CA
Practice address
125 N Euclid St
Fullerton, CA 92832-1618
Phone
(714) 773-1212
Fax
(714) 773-9900
NPI assigned
Jul 5, 2006
Last updated
Mar 12, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A45839 CA Primary

Addresses

Primary practice location

125 N Euclid St
Fullerton, CA 92832-1618

Mailing address

125 N Euclid St
Fullerton, CA 92832-1618
Phone (714) 773-1212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A45839CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Ji Yon Lee MD, Inc Past Accepting new patients
Walsh Medical Group,a Professional Corporation PastSince Mar 29, 2020 Accepting new patients
Joyce H. Chong M.D. Inc. Past Accepting new patients
Walsh Medical Group, a Professional Corporation PastSince Mar 29, 2020 Accepting new patients
Ahmc Whittier Hospital Medical Center LP Past Accepting new patients
University of California Irvine Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394582400000",
    "number": "1659302230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 N EUCLID ST",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928321618",
            "telephone_number": "714-773-1212",
            "fax_number": "714-773-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 N EUCLID ST",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928321618",
            "telephone_number": "714-773-1212",
            "fax_number": "714-773-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVADIA",
        "first_name": "CYNTHIA",
        "middle_name": "VILLACORTA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2014-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A45839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.