Provider Demographics
NPI:1689774556
Name:SILVAS, MICHAEL D (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:D
Last Name:SILVAS
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 1:1020 VINE ST
Mailing Address - Street 2:
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93446-2559
Mailing Address - Country:US
Mailing Address - Phone:805-239-0644
Mailing Address - Fax:805-239-0656
Practice Address - Street 1:1020 VINE ST
Practice Address - Street 2:
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446-2559
Practice Address - Country:US
Practice Address - Phone:805-239-0644
Practice Address - Fax:805-239-0656
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG50828207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G508280Medicare ID - Type Unspecified
CAA51820Medicare UPIN
CAAR375AMedicare PIN