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General NPI Number Information
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NPI Number | 1710266218
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Entity Type | Organization
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Legal Business Name | SYNGO LLC
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Dates
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Enumeration Date | 08/15/2011
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Last Update Date | 08/15/2011
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Provider Practice Location Address
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Address Line | 1342 PASEO ENCINAS
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City | SAN DIMAS
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State | CA
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Zip | 91773-4217
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Country | US
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Telephone | 909-599-0701
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Fax |
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Provider Business Mailing Address
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Address Line | 421 S ROCK RIVER RD
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City | DIAMOND BAR
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State | CA
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Zip | 91765-1562
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Country | US
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Telephone | 818-481-7818
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Fax | 909-599-0701
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOHN CHOU
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Credential |
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Telephone | 818-481-7818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number |
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License Number State | CA
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