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General NPI Number Information
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NPI Number | 1275313652
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Entity Type | Organization
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Legal Business Name | SYNERGY ORTHOPEDIC SPECIALISTS, INC.
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Dates
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Enumeration Date | 10/03/2023
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Last Update Date | 10/03/2023
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Provider Practice Location Address
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Address Line | 9095 RIO SAN DIEGO DR STE 150
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City | SAN DIEGO
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State | CA
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Zip | 92108-1681
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Country | US
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Telephone | 858-200-3300
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Fax |
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Provider Business Mailing Address
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Address Line | 4445 EASTGATE MALL STE 105
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City | SAN DIEGO
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State | CA
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Zip | 92121-1979
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Country | US
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Telephone | 858-412-6080
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Fax | 858-412-6376
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Authorized Official
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Title or Position | PRESIDENT
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Name | TAL DAVID
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Credential |
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Telephone | 858-412-6080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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