| Silver Family Practice, Inc. | |
|
77 Casa St Suite 104 San Luis Obispo CA 93405-5803 | |
| (805) 788-0200 | |
| (805) 788-0300 |
| Full Name | Silver Family Practice, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 77 Casa St, San Luis Obispo, California |
| Authorized Official Name and Position | Randall M Silver (PRESIDENT) |
| Authorized Official Contact | 8057880200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Silver Family Practice, Inc. 77 Casa St Suite 104 San Luis Obispo CA 93405-5803 Ph: (805) 788-0200 | Silver Family Practice, Inc. 77 Casa St Suite 104 San Luis Obispo CA 93405-5803 Ph: (805) 788-0200 |
| NPI Number | 1558694638 |
|---|---|
| Provider Enumeration Date | 09/08/2009 |
| Last Update Date | 03/13/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558694638 | NPI | - | NPPES |
| 5484078 | Other | AETNA PIN | |
| C3219159 | Other | CA | STATE CORP # |
| ZZZ56109Y | Other | CA | BLUE SHIELD PIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | C3219159 (California) | Primary |
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