Healthcare Provider Details

I. General information

NPI: 1871891606
Provider Name (Legal Business Name): KIMBERLY ANN SILVA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2011
Last Update Date: 01/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 S MAIN ST SUITE525
ORANGE CA
92868-4509
US

IV. Provider business mailing address

505 S MAIN ST SUITE525
ORANGE CA
92868-4509
US

V. Phone/Fax

Practice location:
  • Phone: 714-456-5631
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License NumberA116971
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: