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General NPI Number Information
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NPI Number | 1225868623
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Entity Type | Individual
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Provider Name | CANYBEC SULAYMAN NP
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Gender | Male
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Dates
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Enumeration Date | 08/02/2024
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 29000 S WESTERN AVE STE 205
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City | RANCHO PALOS VERDES
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State | CA
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Zip | 90275-0890
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Country | US
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Telephone | 310-955-1041
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Fax |
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Provider Business Mailing Address
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Address Line | 29000 S WESTERN AVE STE 205
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City | RANCHO PALOS VERDES
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State | CA
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Zip | 90275-0890
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Country | US
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Telephone | 310-955-1041
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083B0002X
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Taxonomy Name | Obesity Medicine (Preventive Medicine) Physician
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License Number | 95031206
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | NP95031206
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95031206
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License Number State | CA
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