Healthcare Provider Details

I. General information

NPI: 1104762327
Provider Name (Legal Business Name): SYNERGY ORTHOPEDIC SPECIALISTS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 SPRING ST STE 180
LA MESA CA
91942-0272
US

IV. Provider business mailing address

4700 SPRING ST STE 180
LA MESA CA
91942-0272
US

V. Phone/Fax

Practice location:
  • Phone: 619-797-1190
  • Fax:
Mailing address:
  • Phone: 619-797-1190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: TAL DAVID
Title or Position: PRESIDENT
Credential:
Phone: 858-412-6080