Healthcare Provider Details

I. General information

NPI: 1528242666
Provider Name (Legal Business Name): SIMMS PARK EMERGENCY PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2007
Last Update Date: 01/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9542 ARTESIA BLVD
BELLFLOWER CA
90706-6511
US

IV. Provider business mailing address

3916 STATE ST #300
SANTA BARBARA CA
93105-5602
US

V. Phone/Fax

Practice location:
  • Phone: 562-925-8355
  • Fax:
Mailing address:
  • Phone: 805-563-3010
  • Fax: 805-564-5087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHARLES T MITCHELL
Title or Position: GENERAL PARTNER
Credential: M.D.
Phone: 805-563-3011