Provider Demographics
NPI:1336351063
Name:SILVERBERG, LEONARD (DPM)
Entity type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:
Last Name:SILVERBERG
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:DR
Other - First Name:LEONARD
Other - Middle Name:
Other - Last Name:SILVERBERG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:5907 LANKERSHIM BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91601-1006
Mailing Address - Country:US
Mailing Address - Phone:918-980-3073
Mailing Address - Fax:877-340-3470
Practice Address - Street 1:5907 LANKERSHIM BLVD
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91601-1006
Practice Address - Country:US
Practice Address - Phone:818-980-3073
Practice Address - Fax:877-340-3470
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE1360213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADN881AMedicare UPIN