Provider Demographics
NPI:1679797542
Name:SILVERMAN, STANLEY R (MD)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:R
Last Name:SILVERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:415 ROLLING OAKS DR
Mailing Address - Street 2:STE 220
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91361-1046
Mailing Address - Country:US
Mailing Address - Phone:805-497-8638
Mailing Address - Fax:805-495-3858
Practice Address - Street 1:317 SO MOORPARK ROAD
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91361
Practice Address - Country:US
Practice Address - Phone:805-497-8638
Practice Address - Fax:805-495-3858
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC27941207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WC27941AMedicare ID - Type Unspecified
A33497Medicare UPIN