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SYNERGY CARDIOTHORACIC SURGERY MEDICAL GROUP NPI 1063721330


NPI Information

NPI: 1063721330
Provider Name: SYNERGY CARDIOTHORACIC SURGERY MEDICAL GROUP
Classification: Thoracic Surgery (Cardiothoracic Vascular Surgery) - 208G00000X
Entity Type: Organization
Address:
901 SAN BERNARDINO RD
SUITE102
UPLAND, CA
ZIP 91786
Phone: (909) 579-6721
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SYNERGY CARDIOTHORACIC SURGERY MEDICAL GROUP is a thoracic surgery cardiothoracic vascular surgery in Upland, CA. The provider is a thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. SYNERGY CARDIOTHORACIC SURGERY MEDICAL GROUP NPI is 1063721330. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

901 SAN BERNARDINO RD
SUITE102
UPLAND, CA
ZIP 91786-912
Phone: (909) 579-6721
Fax: (909) 579-6737

The provider's authorized official is Nan Wang .
The authorized official title is President and has the following contact phone number (909) 579-6721.

The enumeration date for this NPI number is 10/4/2010 and was last updated on 3/20/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery)G55739CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1E91894MEDICARE UPINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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