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General NPI Number Information
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NPI Number | 1891805826
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Entity Type | Individual
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Provider Name | CYNTHIA M MATHIS M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 06/25/2008
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Provider Practice Location Address
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Address Line | 239 S LA CIENEGA BLVD SUITE 200
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-3328
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Country | US
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Telephone | 310-659-9566
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Fax | 310-329-0176
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Provider Business Mailing Address
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Address Line | PO BOX 5333
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City | TORRANCE
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State | CA
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Zip | 90510-5333
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Country | US
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Telephone | 310-329-2469
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Fax | 310-329-0176
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | G79441
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License Number State | CA
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