Provider Demographics
NPI:1407208549
Name:BROWN, CYNTHIA ANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ANN
Last Name:BROWN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3941 PARK DR
Mailing Address - Street 2:SUITE 20-530
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-4549
Mailing Address - Country:US
Mailing Address - Phone:916-293-9170
Mailing Address - Fax:
Practice Address - Street 1:3941 PARK DR
Practice Address - Street 2:SUITE 20-530
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-4549
Practice Address - Country:US
Practice Address - Phone:916-293-9170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-12
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47535183500000X
NV12043183500000X
VA0202210271183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist