Healthcare Provider Details

I. General information

NPI: 1780927368
Provider Name (Legal Business Name): SYLVIA ASHOUR MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2013
Last Update Date: 04/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 S LAKE AVE STE 535
PASADENA CA
91101-3005
US

IV. Provider business mailing address

PO BOX 60790
PASADENA CA
91116-6790
US

V. Phone/Fax

Practice location:
  • Phone: 626-795-6596
  • Fax: 626-795-8247
Mailing address:
  • Phone: 626-795-6596
  • Fax: 626-795-8247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA97354
License Number StateCA

VIII. Authorized Official

Name: DR. SYLVIA ASHOUR
Title or Position: PRESIDENT
Credential: MD
Phone: 323-244-8066