Healthcare Provider Details

I. General information

NPI: 1073554101
Provider Name (Legal Business Name): MICHAEL J. SILKA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 01/13/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4650 W SUNSET BLVD
LOS ANGELES CA
90027-6062
US

IV. Provider business mailing address

3701 WILSHIRE BLVD STE 600
LOS ANGELES CA
90010-2804
US

V. Phone/Fax

Practice location:
  • Phone: 323-361-3500
  • Fax: 323-361-8052
Mailing address:
  • Phone: 626-457-5839
  • Fax: 626-457-4079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberG85274
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: