1881394393 NPI number — MARIA DEL ROSARIO SILVA MACIAS

Table of content: MARIA DEL ROSARIO SILVA MACIAS (NPI 1881394393)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881394393 NPI number — MARIA DEL ROSARIO SILVA MACIAS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SILVA MACIAS
Provider First Name:
MARIA
Provider Middle Name:
DEL ROSARIO
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

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:
1881394393
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/06/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
801 CORPORATE CENTER DR STE 210
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
POMONA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91768-2627
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
909-618-0974
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
26696 9TH ST
Provider Second Line Business Practice Location Address:
APT 171
Provider Business Practice Location Address City Name:
HIGHLAND
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92346-3065
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-367-7630
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/06/2023

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: 106S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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