Provider Demographics
NPI:1457539942
Name:MELVIN J. SILVERSTEIN, M.D., A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:MELVIN J. SILVERSTEIN, M.D., A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MELVIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SILVERSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MB
Authorized Official - Phone:949-764-8281
Mailing Address - Street 1:1 HOAG DR., P.O. BOX 6100
Mailing Address - Street 2:HOAG BREAST CARE CENTER
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-4162
Mailing Address - Country:US
Mailing Address - Phone:949-764-8281
Mailing Address - Fax:949-764-8236
Practice Address - Street 1:1 HOAG DR
Practice Address - Street 2:HOAG BREAST CARE CENTER
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-4162
Practice Address - Country:US
Practice Address - Phone:949-764-8281
Practice Address - Fax:949-764-8236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG23100208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G231000Medicaid
CAA41853Medicare UPIN
CAWG23100Medicare PIN