Tjahjadi, Cynthia
Tjahjadi, Cynthia is an sole proprietor health care provider with primary practice located at 1447 W Whittier Blvd , La Habra CA 90631-3614. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Tjahjadi, Cynthia can be contacted via phone (562) 697-3995.Contact Information
Primary practice address
1447 W Whittier Blvd
La Habra CA 90631-3614
Phone: (562) 697-3995
Fax: (562) 697-3446
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 9158T | California |
Profile Details
| NPI number | 1255413324 |
|---|---|
| LBN Legal business name | Tjahjadi, Cynthia |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 19th, 2006 |
| Last updated | Apr 22nd, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255413324 | NPPES |
| California | MEDICAID | GSD001180 | |
| California | MEDICAID | SD0091580 |
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