Provider Demographics
NPI:1487842720
Name:SYN, GENE LLOYD (MD)
Entity Type:Individual
Prefix:
First Name:GENE
Middle Name:LLOYD
Last Name:SYN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23961 CALLE DE LA MAGDALENA
Mailing Address - Street 2:SUITE 231
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-3616
Mailing Address - Country:US
Mailing Address - Phone:949-609-0500
Mailing Address - Fax:949-609-0504
Practice Address - Street 1:23961 CALLE DE LA MAGDALENA
Practice Address - Street 2:SUITE 231
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-3616
Practice Address - Country:US
Practice Address - Phone:949-609-0500
Practice Address - Fax:949-609-0504
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-11
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG79692208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG69030Medicare UPIN
CAWG79692BMedicare PIN