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General NPI Number Information
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NPI Number | 1205036928
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Entity Type | Organization
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Legal Business Name | SYLVIA SURGICAL ASSISTANT, INC.
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Dates
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Enumeration Date | 07/20/2007
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Last Update Date | 10/02/2008
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Provider Practice Location Address
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Address Line | 7033 STEWART AND GRAY RD UNIT 38
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City | DOWNEY
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State | CA
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Zip | 90241-4355
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Country | US
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Telephone | 562-708-9729
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4808
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City | DOWNEY
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State | CA
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Zip | 90241-1808
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Country | US
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Telephone | 562-702-9729
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OFFICER
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Name | CECIL REYES
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Credential | PAC
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Telephone | 562-708-9729
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA16338
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License Number State | CA
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