Provider Demographics
NPI:1538596721
Name:SILVA, MARTIN (RCP15920)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:
Last Name:SILVA
Suffix:
Gender:M
Credentials:RCP15920
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3638 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92501-3331
Mailing Address - Country:US
Mailing Address - Phone:951-233-1888
Mailing Address - Fax:
Practice Address - Street 1:3638 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-3331
Practice Address - Country:US
Practice Address - Phone:951-233-1888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-02
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARCP159202278G1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGeneral Care