Provider Demographics
NPI:1215195888
Name:LAURENCE M. SILVERSTEIN, M.D., INC
Entity Type:Organization
Organization Name:LAURENCE M. SILVERSTEIN, M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURENCE
Authorized Official - Middle Name:M
Authorized Official - Last Name:SILVERSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-345-2323
Mailing Address - Street 1:5620 WILBUR AVE
Mailing Address - Street 2:200
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-1351
Mailing Address - Country:US
Mailing Address - Phone:818-345-2323
Mailing Address - Fax:818-345-2061
Practice Address - Street 1:5620 WILBUR AVE
Practice Address - Street 2:200
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-1351
Practice Address - Country:US
Practice Address - Phone:818-345-2323
Practice Address - Fax:818-345-2061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA92426Medicare UPIN