Healthcare Provider Details

I. General information

NPI: 1699881151
Provider Name (Legal Business Name): JOHN SILVA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 CIRCLE DR
SALINAS CA
93905-2150
US

IV. Provider business mailing address

522 COLLEGE DR
SALINAS CA
93901-1506
US

V. Phone/Fax

Practice location:
  • Phone: 831-757-6237
  • Fax: 831-757-8458
Mailing address:
  • Phone: 831-424-4480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG54112
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: