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General NPI Number Information
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NPI Number | 1689991499
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Entity Type | Organization
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Legal Business Name | SYNERGY MEDICAL SPECIALISTS, P.C.
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Dates
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Enumeration Date | 05/03/2010
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Last Update Date | 09/05/2020
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Provider Practice Location Address
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Address Line | 27700 MEDICAL CENTER RD
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City | MISSION VIEJO
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State | CA
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Zip | 92691-6426
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Country | US
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Telephone | 949-612-2727
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Fax | 949-612-2727
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Provider Business Mailing Address
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Address Line | 555 N EL CAMINO REAL # A389
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City | SAN CLEMENTE
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State | CA
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Zip | 92672-6740
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Country | US
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Telephone | 949-612-2727
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Fax | 949-612-2727
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Authorized Official
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Title or Position | OWNER
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Name | MR. JASON M MILLER
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Credential | MD
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Telephone | 949-612-2727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A78072
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A82629
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | A82629
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 2084P0015X
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Taxonomy Name | Psychosomatic Medicine Physician
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License Number | A78072
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License Number State | CA
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