Healthcare Provider Details

I. General information

NPI: 1003918996
Provider Name (Legal Business Name): SIMON LAVI, D.O.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7700 IMPERIAL HWY SUITE R
DOWNEY CA
90242-3469
US

IV. Provider business mailing address

7700 IMPERIAL HWY SUITE R
DOWNEY CA
90242-3469
US

V. Phone/Fax

Practice location:
  • Phone: 562-803-0600
  • Fax: 562-401-4307
Mailing address:
  • Phone: 562-803-0600
  • Fax: 562-401-4307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number20A7777
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number20A7777
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number20A7777
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number20A7777
License Number StateCA

VIII. Authorized Official

Name: SIMON LAVI
Title or Position: OWNER
Credential:
Phone: 562-803-0600