Healthcare Provider Details

I. General information

NPI: 1932159225
Provider Name (Legal Business Name): SYLVIA OSORIO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 03/07/2023
Certification Date: 02/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1045 W REDONDO BEACH BLVD
GARDENA CA
90247-4128
US

IV. Provider business mailing address

4161 REDONDO BEACH BLVD SUITE 201
LAWNDALE CA
90260-3340
US

V. Phone/Fax

Practice location:
  • Phone: 310-352-4170
  • Fax: 310-324-7956
Mailing address:
  • Phone: 310-214-8677
  • Fax: 310-921-1718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG56557
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: