Healthcare Provider Details

I. General information

NPI: 1487842720
Provider Name (Legal Business Name): GENE LLOYD SYN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2007
Last Update Date: 10/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23961 CALLE DE LA MAGDALENA SUITE 231
LAGUNA HILLS CA
92653-3616
US

IV. Provider business mailing address

23961 CALLE DE LA MAGDALENA SUITE 231
LAGUNA HILLS CA
92653-3616
US

V. Phone/Fax

Practice location:
  • Phone: 949-609-0500
  • Fax: 949-609-0504
Mailing address:
  • Phone: 949-609-0500
  • Fax: 949-609-0504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License NumberG79692
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: