Organization
EMERALD ISLE MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BERTRAND DE SILVA M.D. (OWNER)
(714) 444-0440
Entity
Organization
Contact information
Practice address
4121 BROCKTON AVE STE 104, RIVERSIDE, CA 92501-3442
(951) 778-0032
Mailing address
4121 BROCKTON AVE STE 104, RIVERSIDE, CA 92501-3442
(951) 778-0032
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A46400
CA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
A46400
CA
207RP1001X
Pulmonary Disease Physician
A46400
CA
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
A46400
CA
Other
Enumeration date
10/17/2007
Last updated
02/07/2020
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