=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366674574
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GEORGE CYRIL MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/20/2009
-----------------------------------------------------
Last Update Date | 03/23/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8929 WILSHIRE BLVD STE 302
-----------------------------------------------------
City | BEVERLY HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90211-1974
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-881-3730
-----------------------------------------------------
Fax | 310-595-1063
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8929 WILSHIRE BLVD STE 302
-----------------------------------------------------
City | BEVERLY HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90211-1974
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-881-3730
-----------------------------------------------------
Fax | 310-595-1063
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208100000X
-----------------------------------------------------
Taxonomy Name | Physical Medicine & Rehabilitation
-----------------------------------------------------
License Number | 269397
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208100000X
-----------------------------------------------------
Taxonomy Name | Physical Medicine & Rehabilitation
-----------------------------------------------------
License Number | A125759
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------