Provider Demographics
NPI:1902950405
Name:BOXRUD, CYNTHIA A (MD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:A
Last Name:BOXRUD
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2021 SANTA MONICA BLVD STE 408E
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2144
Mailing Address - Country:US
Mailing Address - Phone:310-829-9060
Mailing Address - Fax:310-829-9015
Practice Address - Street 1:2021 SANTA MONICA BLVD STE 408E
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2144
Practice Address - Country:US
Practice Address - Phone:310-829-9060
Practice Address - Fax:310-829-9015
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA50569207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA50569EMedicare PIN
A50569Medicare PIN