Provider Demographics
NPI:1275073728
Name:SILVA, ROBERT STEVE (ABO OPTICIAN)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:STEVE
Last Name:SILVA
Suffix:
Gender:M
Credentials:ABO OPTICIAN
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:23010 LAKE FOREST DR
Mailing Address - Street 2:STE A
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-1351
Mailing Address - Country:US
Mailing Address - Phone:949-586-4211
Mailing Address - Fax:949-586-1549
Practice Address - Street 1:23010 LAKE FOREST DR
Practice Address - Street 2:STE A
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-1351
Practice Address - Country:US
Practice Address - Phone:949-586-4211
Practice Address - Fax:949-586-1549
Is Sole Proprietor?:No
Enumeration Date:2017-03-02
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASL6618156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician