Provider Demographics
NPI:1124020409
Name:MORGAN, SYLVIA LEE (MD)
Entity Type:Individual
Prefix:MS
First Name:SYLVIA
Middle Name:LEE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA65899174400000X
CAA065899174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A65899Medicaid
CAEJ475ZMedicare PIN
CAG83343Medicare UPIN
CAEJ465AMedicare PIN