Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | DC21802 | CA |
NPI | 1275676835 |
---|---|
Provider Name | Dr. Giovanni Silva |
First Address | Hermosa Beach, CA 90254-3955 |
Second Address | Hermosa Beach, CA 90254-3955 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2007 |
Last Update Date | 08/07/2007 |