Provider Demographics
NPI:1346298312
Name:SILVERIA, FRED (DC)
Entity Type:Individual
Prefix:DR
First Name:FRED
Middle Name:
Last Name:SILVERIA
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 1:7601 SUNRISE BLVD
Mailing Address - Street 2:STE.# 8
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-2343
Mailing Address - Country:US
Mailing Address - Phone:916-721-5677
Mailing Address - Fax:916-721-5676
Practice Address - Street 1:7601 SUNRISE BLVD
Practice Address - Street 2:STE.# 8
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-2343
Practice Address - Country:US
Practice Address - Phone:916-721-5677
Practice Address - Fax:916-721-5676
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12278111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT04701Medicare UPIN