Provider Demographics
NPI:1518267392
Name:STUART L SILVERMAN MD A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:STUART L SILVERMAN MD A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:L
Authorized Official - Last Name:SILVERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-358-2234
Mailing Address - Street 1:8641 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2900
Mailing Address - Country:US
Mailing Address - Phone:310-358-2234
Mailing Address - Fax:310-659-1849
Practice Address - Street 1:8641 WILSHIRE BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2900
Practice Address - Country:US
Practice Address - Phone:310-358-2234
Practice Address - Fax:310-659-1849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-27
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC39893261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA88146Medicare UPIN