1679670822 NPI number — DR. STUART L SILVERMAN MD

Table of content: DR. STUART L SILVERMAN MD (NPI 1679670822)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679670822 NPI number — DR. STUART L SILVERMAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SILVERMAN
Provider First Name:
STUART
Provider Middle Name:
L
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1679670822
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/18/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8641 WILSHIRE BLVD
Provider Second Line Business Mailing Address:
#301
Provider Business Mailing Address City Name:
BEVERLY HILLS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90211
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-358-2234
Provider Business Mailing Address Fax Number:
310-659-2841

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8641 WILSHIRE BLVD
Provider Second Line Business Practice Location Address:
#301
Provider Business Practice Location Address City Name:
BEVERLY HILLS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90211
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-358-2234
Provider Business Practice Location Address Fax Number:
310-659-2841
Provider Enumeration Date:
09/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  C39893 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: C39893 . This is a "LICENSE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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