Provider Demographics
NPI:1952604217
Name:SILVER, ANDREW J (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:J
Last Name:SILVER
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6320 COMMODORE SLOAT DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-5453
Mailing Address - Country:US
Mailing Address - Phone:323-935-3420
Mailing Address - Fax:323-935-5933
Practice Address - Street 1:434 S SAN VICENTE BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-4108
Practice Address - Country:US
Practice Address - Phone:310-360-6780
Practice Address - Fax:310-360-6789
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-08
Last Update Date:2014-04-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG55448207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG55448OtherMEDICAL LICENSE #