Jorge Luis Silva, IDC

Primary specialty

Independent Duty Medical TechniciansTaxonomy code 1710I1003X

License

1194336842 Issued in CA

Practice address

PO Box 128
Kekaha, HI 96752-0128

Phone

(949) 619-0863

NPI assigned

Aug 14, 2020

Last updated

Jul 25, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1597363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1194336842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 128",
            "city": "KEKAHA",
            "state": "HI",
            "postal_code": "967520128",
            "telephone_number": "949-619-0863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 128",
            "city": "KEKAHA",
            "state": "HI",
            "postal_code": "967520128",
            "telephone_number": "949-619-0863"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6905 harris ave",
            "address_purpose": "LOCATION",
            "city": "kailua",
            "state": "HI",
            "postal_code": "96734",
            "country_code": "US",
            "telephone_number": "949-619-0863",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SILVA",
        "first_name": "JORGE",
        "middle_name": "LUIS",
        "credential": "IDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-14",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1710I1003X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Medical Technicians",
            "state": "CA",
            "license": "1194336842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Independent Duty Medical Technicians in Kekaha, HI
• Providers in Kekaha, HI by specialty
• Independent Duty Medical Technicians in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.