Provider Demographics
NPI:1922112358
Name:RUI A DA SILVA, M.D., INC.
Entity Type:Organization
Organization Name:RUI A DA SILVA, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RUI
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:DA SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-365-7651
Mailing Address - Street 1:58471 29 PALMS HWY
Mailing Address - Street 2:SUITE 203
Mailing Address - City:YUCCA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92284-5818
Mailing Address - Country:US
Mailing Address - Phone:760-365-7651
Mailing Address - Fax:760-365-6050
Practice Address - Street 1:58471 29 PALMS HWY
Practice Address - Street 2:SUITE 203
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-5818
Practice Address - Country:US
Practice Address - Phone:760-365-7651
Practice Address - Fax:760-365-6050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA897170207R00000X
CAA33298207X00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A332980Medicaid
CAA33298OtherDR. D LIC.
CAA89717OtherDR. SAMALA LIC
CAA27102Medicare UPIN
CA00A332980Medicaid
CA0314040001Medicare NSC