Provider Demographics
NPI:1790489896
Name:BROOKS, BRIZA CYNTHIA (OD)
Entity Type:Individual
Prefix:MS
First Name:BRIZA
Middle Name:CYNTHIA
Last Name:BROOKS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:BRIZA
Other - Middle Name:CYNTHIA
Other - Last Name:BROOKS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:795 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-2007
Mailing Address - Country:US
Mailing Address - Phone:909-623-6116
Mailing Address - Fax:
Practice Address - Street 1:795 E 2ND ST
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-2007
Practice Address - Country:US
Practice Address - Phone:909-623-6116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35314-TLG152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation