1023876976 NPI number — SILVER SUMMIT MEDICAL CORPORATION

Table of content: (NPI 1023876976)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023876976 NPI number — SILVER SUMMIT MEDICAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SILVER SUMMIT MEDICAL CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023876976
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/24/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
548 MARKET ST UNIT 5020
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN FRANCISCO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94104-5401
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-699-8829
Provider Business Mailing Address Fax Number:
661-324-4600

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1408 COMMERCIAL WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93309-0406
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-727-7000
Provider Business Practice Location Address Fax Number:
661-324-4600
Provider Enumeration Date:
03/06/2024

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KUMAR
Authorized Official First Name:
VINOD
Authorized Official Middle Name:
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
661-727-0000

Provider Taxonomy Codes

  • Taxonomy code: 163WW0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2086S0122X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)