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General NPI Number Information
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NPI Number | 1275037681
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Entity Type | Individual
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Provider Name | JACK PHILIP SILVA MD
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Gender | Male
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Dates
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Enumeration Date | 03/20/2018
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 1560 E CHEVY CHASE DR STE 430
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City | GLENDALE
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State | CA
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Zip | 91206-4140
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Country | US
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Telephone | 818-243-1135
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Fax |
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Provider Business Mailing Address
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Address Line | 3800 LEGION LN
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City | LOS ANGELES
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State | CA
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Zip | 90039-1423
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Country | US
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Telephone | 916-847-2583
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A165012
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License Number State | CA
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