Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | A21421 | CA |
N | 2080P0201X | Pediatric Allergist | A21421 | CA |
NPI | 1184668444 |
---|---|
Provider Name | Mr. Seymour Silverberg |
First Address | Northridge, CA 91325 |
Second Address | Northridge, CA 91325 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 21/11/2011 |