Healthcare Provider Details

I. General information

NPI: 1669734711
Provider Name (Legal Business Name): PARVIN D. SYAL M.D. INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2012
Last Update Date: 08/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1174 AMAZON WAY
SIMI VALLEY CA
93065-3156
US

IV. Provider business mailing address

1174 AMAZON WAY
SIMI VALLEY CA
93065-3156
US

V. Phone/Fax

Practice location:
  • Phone: 805-527-7000
  • Fax: 818-475-1987
Mailing address:
  • Phone: 805-527-7000
  • Fax: 818-475-1987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA37754
License Number StateCA

VIII. Authorized Official

Name: DR. PARVIN D SYAL
Title or Position: OWNER
Credential: MD
Phone: 805-527-7000