Provider Demographics
NPI:1588755466
Name:SILVERSTEIN, LAURENCE MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:LAURENCE
Middle Name:MICHAEL
Last Name:SILVERSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23130 PARK MARCO POLO
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-2823
Mailing Address - Country:US
Mailing Address - Phone:818-667-8530
Mailing Address - Fax:818-345-2061
Practice Address - Street 1:5620 WILBUR AVE
Practice Address - Street 2:200
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356
Practice Address - Country:US
Practice Address - Phone:818-345-0601
Practice Address - Fax:818-345-2061
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG43592207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
W22580OtherMEDICARE P-TAN
CAA92426Medicare UPIN
CAWG43592AMedicare ID - Type Unspecified