Synergy Cardiothoracic Surgery Medical Group

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

G55739 Issued in CA

Legal business name

SYNERGY CARDIOTHORACIC SURGERY MEDICAL GROUP

Practice address

901 San Bernardino Rd
Suite102
Upland, CA 91786-4912

Phone

(909) 579-6721

Fax

(909) 579-6737

NPI assigned

Oct 4, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Nan Wang, MD

Title

President

Phone

(909) 579-6721

Specialties & licenses 1

Addresses

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1286150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489968000000",
    "number": "1063721330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 SAN BERNARDINO RD",
            "address_2": "SUITE102",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864912",
            "telephone_number": "909-579-6721",
            "fax_number": "909-579-6737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 SAN BERNARDINO RD",
            "address_2": "SUITE102",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864912",
            "telephone_number": "909-579-6721",
            "fax_number": "909-579-6737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY CARDIOTHORACIC SURGERY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-04",
        "last_updated": "2017-03-20",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "NAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-579-6721",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CA",
            "license": "G55739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Swindle, PPS, APCC
• Debra Swope
• Syed Ahmed Foot & Ankle Consultants
• Sana Syed, PHARMD, RPH
• James William Symonds, DDS
• Synergy CT Surgery Partnership
• Sean S. Szeja, M.D.
• T.H.E. Inc
• Negar Tabandeh, DDS, MS
• Linda Tai, PA-C

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Upland, CA
• Providers in Upland, CA by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.