Individual
CYNTHIA RENEE BRYANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
3868 W CARSON ST STE 331, TORRANCE, CA 90503-6711
(310) 543-9530
(310) 543-9531
Mailing address
PO BOX 3206, PALOS VERDES PENINSULA, CA 90274-9206
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G79748
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G797480
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
10/20/2006
Last updated
04/02/2008
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