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General NPI Number Information
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NPI Number | 1346936853
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Entity Type | Organization
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Legal Business Name | SYLMAR MEDICAL PC
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Dates
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Enumeration Date | 04/17/2023
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Last Update Date | 05/05/2023
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Provider Practice Location Address
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Address Line | 5612 VAN NUYS BLVD
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City | SHERMAN OAKS
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State | CA
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Zip | 91401-4602
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Country | US
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Telephone | 818-357-5459
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Fax |
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Provider Business Mailing Address
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Address Line | 20274 VIA MEDICI
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City | PORTER RANCH
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State | CA
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Zip | 91326-4059
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Country | US
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Telephone | 818-425-4309
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. LAWRENCE VERNON TUCKER
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Credential | MD
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Telephone | 949-390-4730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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