Organization Active NPI

Sergey Lyass MD Surgical

  • Surgery Physician
  • Los Angeles, CA
National Provider Identifier
1639720097
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
SERGEY LYASS MD SURGICAL
Practice address
6404 Wilshire Blvd Ste 701
Los Angeles, CA 90048-5509
Phone
(604) 623-1786
Fax
(310) 623-1922
NPI assigned
Sep 26, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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

Authorized official

Name
Sergey LyassNPI 1316996911
Title
President
Phone
(310) 623-1786

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

6404 Wilshire Blvd Ste 701
Los Angeles, CA 90048-5509

Mailing address

6404 Wilshire Blvd Ste 701
Los Angeles, CA 90048-5509
Phone (310) 623-1786

National Provider Directory

National Provider Directory

Locations

8631 W 3rd St
#S900E
Los Angeles, CA 90048

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1569456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764806400000",
    "number": "1639720097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6404 WILSHIRE BLVD STE 701",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485509",
            "telephone_number": "310-623-1786",
            "fax_number": "310-623-1922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6404 WILSHIRE BLVD STE 701",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485509",
            "telephone_number": "604-623-1786",
            "fax_number": "310-623-1922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERGEY LYASS MD SURGICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-26",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A",
        "authorized_official_last_name": "LYASS",
        "authorized_official_first_name": "SERGEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-623-1786"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2025; 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.