Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | G3756 | CA |
Y | 207QA0505X | Family Doctor - Adult Medicine | G3756 | CA |
NPI | 1215968086 |
---|---|
Provider Name | Melvin Silverman |
First Address | Bakersfield, CA 93309-1104 |
Second Address | Frazier Park, CA 93225 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 03/11/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C46508 | (02) | CA |