Healthcare Provider Details

I. General information

NPI: 1912325135
Provider Name (Legal Business Name): SILVIA AKI MCCANDLISH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2014
Last Update Date: 05/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 WEBSTER ST STE 516
SAN FRANCISCO CA
94115
US

IV. Provider business mailing address

2350 W EL CAMINO REAL FL 2
MOUNTAIN VIEW CA
94040-6203
US

V. Phone/Fax

Practice location:
  • Phone: 415-600-3190
  • Fax: 415-369-1391
Mailing address:
  • Phone: 415-600-3190
  • Fax: 415-369-1391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA138864
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberA138864
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: