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Individual

JORGE LUIS SILVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
IDC

Contact information

Practice address
PO BOX 128, KEKAHA, HI 96752-0128
(949) 619-0863
Mailing address
PO BOX 128, KEKAHA, HI 96752-0128
(949) 619-0863

Taxonomy

Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
1710I1003X
Independent Duty Medical Technicians
Primary
1194336842
CA

Other

Enumeration date
08/14/2020
Last updated
07/25/2025
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