MEDICARE: DR. KENNETH JAY SILVER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	GO59984	CA
2	208M00000X	Hospitalist Physician	G59984	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G59984	OTHER	CA	MEDICAL LICENSE

General Provider Information

NPI Number	:	1073628079
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENNETH JAY SILVER M.D.

Provider Business Mailing Address
First Line	:	PO BOX 320927
Second Line	:
City	:	LOS GATOS
State	:	CA
Zip	:	95032-0115
Country	:	US
Telephone Number	:	408-857-4061
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 W PARR AVE
Second Line	:	SUITE R
City	:	LOS GATOS
State	:	CA
Zip	:	95032-1442
Country	:	US
Telephone Number	:	408-857-4061
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	04/13/2010

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