Provider Demographics
NPI:1033414909
Name:SYLVIA MORGAN M.D. INC
Entity Type:Organization
Organization Name:SYLVIA MORGAN M.D. INC
Other - Org Name:SYLVIA LEE MORGAN MD PROFESSIONAL CORP
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:831-634-4666
Mailing Address - Street 1:191 SAN FELIPE RD STE P
Mailing Address - Street 2:
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-3036
Mailing Address - Country:US
Mailing Address - Phone:831-634-4666
Mailing Address - Fax:831-634-4669
Practice Address - Street 1:191 SAN FELIPE RD STE P
Practice Address - Street 2:
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-3036
Practice Address - Country:US
Practice Address - Phone:831-634-4666
Practice Address - Fax:831-634-4669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-24
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA065899174400000X
CAA65899207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1124020409Medicaid
CA00A65899Medicaid
CAEJ475ZMedicare PIN
CA1124020409Medicaid