Provider Demographics
NPI:1184665747
Name:SILVA, RAYMOND (MD)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:
Last Name:SILVA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 SAMARITAN DR STE D103
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-4104
Mailing Address - Country:US
Mailing Address - Phone:408-559-1018
Mailing Address - Fax:408-371-3025
Practice Address - Street 1:2550 SAMARITAN DR STE D103
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-4104
Practice Address - Country:US
Practice Address - Phone:408-559-1018
Practice Address - Fax:408-371-3025
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG63084208G00000X
ORMD197886208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOOG630840Medicaid
PG63084OtherPPO
PA1032454670001Medicaid
EG63084OtherCHAMPUS
HG63084OtherHMO
OOG630840OtherMEDI CAL
EG63084OtherCHAMPUS