Provider Demographics
NPI:1952603284
Name:BARRY NEIL SILBERG, M.D., INC.
Entity type:Organization
Organization Name:BARRY NEIL SILBERG, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:NEIL
Authorized Official - Last Name:SILBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-528-0911
Mailing Address - Street 1:1111 SONOMA AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405-4819
Mailing Address - Country:US
Mailing Address - Phone:707-528-0911
Mailing Address - Fax:707-528-4602
Practice Address - Street 1:1111 SONOMA AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-4819
Practice Address - Country:US
Practice Address - Phone:707-528-0911
Practice Address - Fax:707-528-4602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-18
Last Update Date:2014-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA46738Medicare UPIN