Healthcare Provider Details

I. General information

NPI: 1083401269
Provider Name (Legal Business Name): SYNERGEX MED AZ PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2025
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 E HIGHLAND AVE STE 110
PHOENIX AZ
85016-4874
US

IV. Provider business mailing address

5 HOLLAND STE 101
IRVINE CA
92618-2568
US

V. Phone/Fax

Practice location:
  • Phone: 562-414-4452
  • Fax: 562-381-8130
Mailing address:
  • Phone: 949-588-2190
  • Fax: 949-588-2199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number
License Number State

VIII. Authorized Official

Name: HIRSH KAVEESHVAR
Title or Position: PARTNER
Credential: DO
Phone: 562-414-4452