Provider Demographics
NPI:1912019381
Name:SYLVER MEDICAL SERVICES
Entity Type:Organization
Organization Name:SYLVER MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PEACE
Authorized Official - Middle Name:
Authorized Official - Last Name:EBIRIEKWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-412-9262
Mailing Address - Street 1:1202 N LA BREA AVE
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90302-1215
Mailing Address - Country:US
Mailing Address - Phone:310-412-9262
Mailing Address - Fax:310-412-7896
Practice Address - Street 1:1202 N LA BREA AVE
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90302-1215
Practice Address - Country:US
Practice Address - Phone:310-412-9262
Practice Address - Fax:310-412-7896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA102809332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1304940001Medicare NSC