# CYNTHIA MATHIS MD A PROFESSIONAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801160460
- **Authorized official:** DR. CYNTHIA M MATHIS M.D. (OWNER)
- **Authorized official phone:** (310) 641-8111

## Contact information

- **Practice address:** 8930 S SEPULVEDA BLVD STE 200, LOS ANGELES, CA 90045-3624
- **Practice address phone:** (310) 641-8111
- **Practice address fax:** (310) 337-7274
- **Mailing address:** PO BOX 9789, MARINA DEL REY, CA 90295-2189
- **Mailing address phone:** (310) 577-8500
- **Mailing address fax:** (310) 305-7119

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208VP0000X | Pain Medicine Physician | G79441 | CA | Yes |

## Other

- **Enumeration date:** 02/29/2012
- **Last updated:** 07/21/2022