Provider Demographics
NPI:1326316720
Name:SYN, KRIS S (PHD)
Entity Type:Individual
Prefix:DR
First Name:KRIS
Middle Name:S
Last Name:SYN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:KRIS
Other - Middle Name:
Other - Last Name:SYN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:11271 LOCH LOMOND RD
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-2911
Mailing Address - Country:US
Mailing Address - Phone:310-540-5381
Mailing Address - Fax:
Practice Address - Street 1:331 NORTH SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:EL SEGUNDO
Practice Address - State:CA
Practice Address - Zip Code:90245
Practice Address - Country:US
Practice Address - Phone:310-640-9651
Practice Address - Fax:310-414-9942
Is Sole Proprietor?:No
Enumeration Date:2011-12-13
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH49337183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist