Individual
DR. SERGEY LYASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4301 GRIMES PL, ENCINO, CA 91316-4361
(310) 623-1786
(310) 693-5334
Mailing address
4301 GRIMES PL, ENCINO, CA 91316-4361
(818) 578-3388
(310) 693-2603
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A80181
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11542441
CAQH ID#
CA
Enumeration date
05/09/2006
Last updated
10/25/2024
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