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General NPI Number Information
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NPI Number | 1417617143
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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 | 12/21/2021
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Last Update Date | 12/21/2021
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Provider Practice Location Address
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Address Line | 501 N EL CAMINO REAL STE 201
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City | ENCINITAS
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State | CA
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Zip | 92024-1335
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Country | US
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Telephone | 760-436-8667
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Fax | 760-436-2292
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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