Provider Demographics
NPI:1073711461
Name:LO, CYNTHIA ARATA (OD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:ARATA
Last Name:LO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5792 SHIRL ST
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-3325
Mailing Address - Country:US
Mailing Address - Phone:714-220-8698
Mailing Address - Fax:
Practice Address - Street 1:12461 W WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-5511
Practice Address - Country:US
Practice Address - Phone:310-390-6287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13295152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPTAN - WY5748OtherMEDICARE PTAN
CAWY5748Medicare PIN