Healthcare Provider Details

I. General information

NPI: 1851401822
Provider Name (Legal Business Name): AUGUSTO SILVA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 10/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 W ALAMEDA AVE
BURBANK CA
91505-4800
US

IV. Provider business mailing address

8510 BALBOA BLVD 150
NORTHRIDGE CA
91325-5810
US

V. Phone/Fax

Practice location:
  • Phone: 818-846-2546
  • Fax: 818-846-4047
Mailing address:
  • Phone: 818-637-2000
  • Fax: 818-654-3417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA26585
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: