Healthcare Provider Details

I. General information

NPI: 1124065230
Provider Name (Legal Business Name): MICHAEL J. SILBERSTEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 12/14/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 W AVENUE J
LANCASTER CA
93534-2814
US

IV. Provider business mailing address

PO BOX 190
SIMI VALLEY CA
93062-0190
US

V. Phone/Fax

Practice location:
  • Phone: 805-577-2147
  • Fax: 805-522-6401
Mailing address:
  • Phone: 805-577-2147
  • Fax: 805-522-6401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License NumberC51520
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: