Healthcare Provider Details

I. General information

NPI: 1457391468
Provider Name (Legal Business Name): MAURICIO SILVA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MAURICIO CARRENO-SILVA M.D.

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 08/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 W ADAMS BLVD
LOS ANGELES CA
90007
US

IV. Provider business mailing address

403 W ADAMS BLVD
LOS ANGELES CA
90007-2664
US

V. Phone/Fax

Practice location:
  • Phone: 213-742-1000
  • Fax: 213-742-1435
Mailing address:
  • Phone: 213-742-1000
  • Fax: 213-742-1435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License NumberA101859
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: