Provider Demographics
NPI:1902831274
Name:SYNN, H MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:H
Middle Name:MICHAEL
Last Name:SYNN
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:PO BOX 28953
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93729-8953
Mailing Address - Country:US
Mailing Address - Phone:559-299-7700
Mailing Address - Fax:
Practice Address - Street 1:722 MEDICAL CENTER DR E
Practice Address - Street 2:STE 105
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-6810
Practice Address - Country:US
Practice Address - Phone:559-299-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG57415207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G574150Medicaid
CA00G574150Medicare ID - Type Unspecified
CAA90007Medicare UPIN