Provider Demographics
NPI:1336204312
Name:TSYGANOVSKAYA, SOFYA BORISOVNA (MD)
Entity type:Individual
Prefix:DR
First Name:SOFYA
Middle Name:BORISOVNA
Last Name:TSYGANOVSKAYA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1161 SPAZIER AVE
Mailing Address - Street 2:UNIT # 9
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91201-3724
Mailing Address - Country:US
Mailing Address - Phone:818-653-7931
Mailing Address - Fax:818-843-4622
Practice Address - Street 1:1411 W OLIVE AVE
Practice Address - Street 2:SUITES D&E
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-2427
Practice Address - Country:US
Practice Address - Phone:818-653-7931
Practice Address - Fax:818-843-4622
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA84551207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A845510Medicaid