Provider Demographics
NPI:1093031064
Name:SYNERGY WELLNESS GROUP, INC.
Entity Type:Organization
Organization Name:SYNERGY WELLNESS GROUP, INC.
Other - Org Name:SYNERGY WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TROBISCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-878-9100
Mailing Address - Street 1:PO BOX 22317
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93390-2317
Mailing Address - Country:US
Mailing Address - Phone:661-878-9100
Mailing Address - Fax:661-878-9101
Practice Address - Street 1:7910 DOWNING AVE STE 100
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308
Practice Address - Country:US
Practice Address - Phone:661-878-9100
Practice Address - Fax:661-878-9101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-15
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA83160207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherTIN