Provider Demographics
NPI:1851722441
Name:SILVA MCCAULEY ADVANCED CHIROPRACTIC & PHYSICAL THERAPY SMACPT
Entity Type:Organization
Organization Name:SILVA MCCAULEY ADVANCED CHIROPRACTIC & PHYSICAL THERAPY SMACPT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:GIOVANNI
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:DC, CCSP
Authorized Official - Phone:310-372-8551
Mailing Address - Street 1:1200 PACIFIC COAST HWY
Mailing Address - Street 2:203-204
Mailing Address - City:HERMOSA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90254-3955
Mailing Address - Country:US
Mailing Address - Phone:310-372-8551
Mailing Address - Fax:310-372-8945
Practice Address - Street 1:1200 PACIFIC COAST HWY
Practice Address - Street 2:203-204
Practice Address - City:HERMOSA BEACH
Practice Address - State:CA
Practice Address - Zip Code:90254-3955
Practice Address - Country:US
Practice Address - Phone:310-372-8551
Practice Address - Fax:310-372-8945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-06
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
No111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD21802OtherCHIROPRACTIC LICENSE