Provider Demographics
NPI:1275676835
Name:SILVA, GIOVANNI (DC)
Entity Type:Individual
Prefix:DR
First Name:GIOVANNI
Middle Name:
Last Name:SILVA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 PACIFIC COAST HWY STE 204
Mailing Address - Street 2:
Mailing Address - City:HERMOSA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90254-3955
Mailing Address - Country:US
Mailing Address - Phone:310-372-8551
Mailing Address - Fax:310-372-8945
Practice Address - Street 1:1200 PACIFIC COAST HWY STE 204
Practice Address - Street 2:
Practice Address - City:HERMOSA BEACH
Practice Address - State:CA
Practice Address - Zip Code:90254-3955
Practice Address - Country:US
Practice Address - Phone:310-372-8551
Practice Address - Fax:310-372-8945
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC21802111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC21802Medicare ID - Type Unspecified