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General NPI Number Information
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NPI Number | 1306439104
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Entity Type | Organization
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Legal Business Name | SYNERGEX MED
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Dates
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Enumeration Date | 02/12/2021
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Last Update Date | 02/12/2021
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Provider Practice Location Address
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Address Line | 431 S HEWITT ST UNIT B
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City | LOS ANGELES
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State | CA
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Zip | 90013-2215
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Country | US
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Telephone | 562-414-4452
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Fax | 562-381-8130
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Provider Business Mailing Address
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Address Line | PO BOX 3129
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City | TORRANCE
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State | CA
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Zip | 90510-3129
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Country | US
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Telephone | 310-792-3914
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Fax | 855-898-4055
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Authorized Official
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Title or Position | PARTNER
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Name | HIRSH KAVEESHVAR
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Credential | DO
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Telephone | 562-414-4452
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P2900X
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Taxonomy Name | Pain Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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