MEDICARE: ELLEN SILVA

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	225200000X	Physical Therapy Assistant	743	CA

General Provider Information

NPI Number	:	1912604125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELLEN SILVA

Provider Business Mailing Address
First Line	:	14301 BEN NEVIS AVE
Second Line	:
City	:	NORWALK
State	:	CA
Zip	:	90650-5102
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5648 GOTHAM ST
Second Line	:
City	:	BELL GARDENS
State	:	CA
Zip	:	90201-5413
Country	:	US
Telephone Number	:	714-399-5819
Fax Number	:

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

Provider Enumeration Date	:	02/08/2023
Last Update Date	:	02/08/2023

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Directions to “ ELLEN SILVA ” Practice Location

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