Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0004X | Dentist Anesthesiologist | 36263 | CA |
NPI | 1063613875 |
---|---|
Provider Name | Dr. Andreia Minasian Silvera |
First Address | Los Angeles, CA 90067-2001 |
Second Address | Los Angeles, CA 90067-2013 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2007 |
Last Update Date | 18/02/2014 |