Provider Demographics
NPI:1659864320
Name:SYNERGY PHYSICIAN GROUP INC
Entity Type:Organization
Organization Name:SYNERGY PHYSICIAN GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:PEARL
Authorized Official - Middle Name:
Authorized Official - Last Name:TSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-940-5483
Mailing Address - Street 1:506 W VALLEY BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-5716
Mailing Address - Country:US
Mailing Address - Phone:626-308-9990
Mailing Address - Fax:626-493-2600
Practice Address - Street 1:600 N GARFIELD AVE STE 107
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1168
Practice Address - Country:US
Practice Address - Phone:626-288-8288
Practice Address - Fax:626-288-9488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-07
Last Update Date:2019-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty