Healthcare Provider Details

I. General information

NPI: 1457470320
Provider Name (Legal Business Name): SYNERGY HEALTH MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 12/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7230 MEDICAL CENTER DR SUTOIE 503
WEST HILLS CA
91307-1907
US

IV. Provider business mailing address

7230 MEDICAL CENTER DR SUITE 503
WEST HILLS CA
91307-1907
US

V. Phone/Fax

Practice location:
  • Phone: 818-884-2585
  • Fax: 818-484-2060
Mailing address:
  • Phone: 818-884-2585
  • Fax: 818-484-2060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberG22396
License Number StateCA

VIII. Authorized Official

Name: DR. JAMES M FOX
Title or Position: SOLE PROPRIATOR
Credential: M.D.
Phone: 818-884-2585