Organization
SERGEY LYASS MD A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SERGEY LYASS (PRESIDENT)
(310) 623-1786
Entity
Organization
Contact information
Practice address
6404 WILSHIRE BLVD STE 701, LOS ANGELES, CA 90048-5509
(310) 623-1786
(310) 623-1922
Mailing address
4301 GRIMES PL, ENCINO, CA 91316-4361
(310) 623-1786
(310) 693-5334
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A80181
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2032137
—
CA
Enumeration date
10/27/2006
Last updated
05/13/2026
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