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General NPI Number Information
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NPI Number | 1417135955
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Entity Type | Organization
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Legal Business Name | JAMES A. DE SILVA, DPM, INC.
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Dates
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Enumeration Date | 02/06/2008
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Last Update Date | 10/25/2011
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Provider Practice Location Address
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Address Line | 817 S MAIN ST SUITE A
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City | CORONA
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State | CA
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Zip | 92882-3406
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Country | US
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Telephone | 951-737-1102
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Fax | 951-737-5150
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Provider Business Mailing Address
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Address Line | 817 S MAIN ST SUITE A
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City | CORONA
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State | CA
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Zip | 92882-3406
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Country | US
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Telephone | 951-737-1102
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Fax | 951-737-5150
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES AUGUSTINE DE SILVA
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Credential | DPM
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Telephone | 951-737-1102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E2121
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License Number State | CA
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