Healthcare Provider Details

I. General information

NPI: 1679094213
Provider Name (Legal Business Name): ELIZABETH SILVA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2017
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 E WASHINGTON BLVD
COMMERCE CA
90040-2451
US

IV. Provider business mailing address

6001 E WASHINGTON BLVD
COMMERCE CA
90040-2451
US

V. Phone/Fax

Practice location:
  • Phone: 562-928-9600
  • Fax: 323-477-1738
Mailing address:
  • Phone: 562-928-9600
  • Fax: 323-477-1738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: