| Silvan Medical Consulting, Inc | |
|
2776 Pacific Ave Long Beach CA 90806-2613 | |
| (949) 288-5377 | |
| (774) 209-4466 |
| Full Name | Silvan Medical Consulting, Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2776 Pacific Ave, Long Beach, California |
| Authorized Official Name and Position | Robert G Bota (PRESIDENT) |
| Authorized Official Contact | 2298150219 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Silvan Medical Consulting, Inc 3151 Airway Ave Ste R Costa Mesa CA 92626-4627 Ph: (949) 288-5377 | Silvan Medical Consulting, Inc 2776 Pacific Ave Long Beach CA 90806-2613 Ph: (949) 288-5377 |
| NPI Number | 1003599911 |
|---|---|
| Provider Enumeration Date | 08/08/2023 |
| Last Update Date | 12/27/2023 |
| Certification Date | 12/27/2023 |
| Medicare PECOS PAC ID | 0840636205 |
|---|---|
| Medicare Enrollment ID | O20240308000435 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003599911 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Robert G Bota |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407990773 PECOS PAC ID: 8527086297 Enrollment ID: I20090210000069 |
| Provider Name | Gerald A Maguire |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144300302 PECOS PAC ID: 0244372977 Enrollment ID: I20100119000576 |
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