Individual
CYNTHIA JOY COTHARN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4325 GLENCOE AVE., UNIT 10552, MARINA DEL REY, CA 90292
(310) 489-9985
Mailing address
4325 GLENCOE AVE., UNIT 10552, MARINA DEL REY, CA 90292
(310) 489-9985
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G82137
CA
207RA0401X
Addiction Medicine (Internal Medicine) Physician
G82137
CA
2083X0100X
Occupational Medicine Physician
G82137
CA
Other
Enumeration date
06/07/2021
Last updated
06/07/2021
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