Healthcare Provider Details
I. General information
NPI: 1871735365
Provider Name (Legal Business Name): SYLVIA ASHOUR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/30/2009
Last Update Date: 08/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1420 S CENTRAL AVE
GLENDALE CA
91204-2508
US
IV. Provider business mailing address
225 S LAKE AVE STE 535
PASADENA CA
91101-3005
US
V. Phone/Fax
- Phone: 818-502-1900
- Fax: 818-502-4738
- Phone: 626-795-6596
- Fax: 626-795-8247
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | 35.094232 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | A97354 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: