Healthcare Provider Details

I. General information

NPI: 1790354462
Provider Name (Legal Business Name): DR. IAN ROBERT SILVER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2021
Last Update Date: 06/17/2021
Certification Date: 06/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4951 ARROYO RD
LIVERMORE CA
94550-9650
US

IV. Provider business mailing address

4951 ARROYO RD
LIVERMORE CA
94550-9650
US

V. Phone/Fax

Practice location:
  • Phone: 650-493-5000
  • Fax:
Mailing address:
  • Phone: 925-373-4700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA.02304
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: