Healthcare Provider Details

I. General information

NPI: 1689869943
Provider Name (Legal Business Name): JOHN L SILBERSTEIN R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2007
Last Update Date: 09/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12555 GARDEN GROVE BLVD 102
GARDEN GROVE CA
92843-1902
US

IV. Provider business mailing address

7465 E HUMMINGBIRD CIR
ANAHEIM CA
92808-1706
US

V. Phone/Fax

Practice location:
  • Phone: 714-636-0593
  • Fax:
Mailing address:
  • Phone: 714-280-0745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH23455
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: