Healthcare Provider Details

I. General information

NPI: 1104962828
Provider Name (Legal Business Name): MELVIN SIMRIN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 12/21/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35825 OTTAWA ST
CATHEDRAL CITY CA
92234-1720
US

IV. Provider business mailing address

35825 OTTAWA ST
CATHEDRAL CITY CA
92234-1720
US

V. Phone/Fax

Practice location:
  • Phone: 760-861-3289
  • Fax: 760-328-1432
Mailing address:
  • Phone: 760-861-3289
  • Fax: 760-328-1432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH26396
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: