Provider Demographics
NPI:1467578963
Name:SILVERBERG, TODD J (OD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:J
Last Name:SILVERBERG
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13257 JAMBOREE RD
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92782
Mailing Address - Country:US
Mailing Address - Phone:714-832-7575
Mailing Address - Fax:
Practice Address - Street 1:13257 JAMBOREE RD
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92782-9158
Practice Address - Country:US
Practice Address - Phone:714-832-7575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10168T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOP10168TMedicare UPIN