Provider Demographics
NPI:1962465310
Name:SILVER, ROY (MD)
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:
Last Name:SILVER
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 1:8631 W 3RD ST STE 444E
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-5908
Mailing Address - Country:US
Mailing Address - Phone:310-652-4252
Mailing Address - Fax:310-652-2688
Practice Address - Street 1:8631 W 3RD ST STE 444E
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5908
Practice Address - Country:US
Practice Address - Phone:310-652-4252
Practice Address - Fax:310-652-2688
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11159174400000X
CAA92178207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100504121Medicaid
CAI22161Medicare UPIN
CAWA92178AMedicare PIN
NV100030Medicare ID - Type Unspecified
NV100504121Medicaid