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General NPI Number Information
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NPI Number | 1295925311
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Entity Type | Individual
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Provider Name | MARILYN SYRETT D.O.
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Gender | Female
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Dates
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Enumeration Date | 07/25/2007
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Last Update Date | 10/20/2008
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Provider Practice Location Address
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Address Line | 3991 MACARTHUR BLVD STE 200
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-3048
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Country | US
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Telephone | 949-310-4393
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Fax | 949-313-1835
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Provider Business Mailing Address
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Address Line | 225 CYPRESS DR
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City | LAGUNA BEACH
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State | CA
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Zip | 92651-1740
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Country | US
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Telephone | 949-310-4393
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Fax | 949-313-1835
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 20A7905
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License Number State | CA
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