Provider Demographics
NPI:1639602527
Name:HAMBLIN, CYNTHIA (OD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:
Last Name:HAMBLIN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:CYNTHIA
Other - Middle Name:
Other - Last Name:HIGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:4051 LONE TREE WAY
Mailing Address - Street 2:SUITE E
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94531-6204
Mailing Address - Country:US
Mailing Address - Phone:925-757-7676
Mailing Address - Fax:925-757-0652
Practice Address - Street 1:4051 LONE TREE WAY
Practice Address - Street 2:SUITE E
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-6204
Practice Address - Country:US
Practice Address - Phone:925-757-7676
Practice Address - Fax:925-757-0652
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-06
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9260T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist