Individual
DR. CYNTHIA BROADY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
17300 17TH ST STE M, TUSTIN, CA 92780-1955
(714) 838-9664
Mailing address
17300 17TH ST STE M, TUSTIN, CA 92780-1955
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
8199T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154452118
NPI
CA
Enumeration date
03/08/2007
Last updated
08/15/2013
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