Provider Demographics
NPI:1619980653
Name:SILBERG, BARRY NEIL (MD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:NEIL
Last Name:SILBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 SONOMA AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405
Mailing Address - Country:US
Mailing Address - Phone:707-528-0911
Mailing Address - Fax:707-528-4602
Practice Address - Street 1:1111 SONOMA AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405
Practice Address - Country:US
Practice Address - Phone:707-528-0911
Practice Address - Fax:707-528-4602
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG036591208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
A46738Medicare UPIN
CAA46738Medicare ID - Type Unspecified