Provider Demographics
NPI:1043453178
Name:SILVA, IRVING B (HIS)
Entity type:Individual
Prefix:
First Name:IRVING
Middle Name:B
Last Name:SILVA
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23440 HAWTHORNE BLVD
Mailing Address - Street 2:SUITE 265
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4780
Mailing Address - Country:US
Mailing Address - Phone:310-345-8165
Mailing Address - Fax:310-375-8181
Practice Address - Street 1:23440 HAWTHORNE BLVD
Practice Address - Street 2:SUITE 265
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4780
Practice Address - Country:US
Practice Address - Phone:310-375-8165
Practice Address - Fax:310-375-8181
Is Sole Proprietor?:No
Enumeration Date:2009-04-20
Last Update Date:2009-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA7428237700000X
CAHIS7428237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist