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NPI Code Detail

MEDICARE: CYRIL SERGEI GARY MD

MEDICARE:   CYRIL SERGEI GARY  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistA194935CA
2390200000XStudent in an Organized Health Care Education/Training Program
3207X00000XOrthopaedic Surgery PhysicianA194935CA

General Provider Information

NPI Number : 1104322205
Entity Type Code : Individual
Provider Name (Legal Business Name) : CYRIL SERGEI GARY MD
Provider Business Mailing Address
First Line : 100 MEDICAL PLAZA SUITE 170
Second Line :
City : LOS ANGELES
State : CA
Zip : 90095-0001
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 100 MEDICAL PLAZA SUITE 170
Second Line :
City : LOS ANGELES
State : CA
Zip : 90095-2113
Country : US
Telephone Number : 310-319-1234
Fax Number : 202-444-7204
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2018
Last Update Date : 07/30/2024

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Directions to “ CYRIL SERGEI GARY MD” Practice Location

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