Healthcare Provider Details

I. General information

NPI: 1043652555
Provider Name (Legal Business Name): SIMA ASH CHOM, C.N.C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2013
Last Update Date: 01/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1714 N BEVERLY GLEN BLVD
LOS ANGELES CA
90077-2710
US

IV. Provider business mailing address

1714 N BEVERLY GLEN BLVD SUITE E
LOS ANGELES CA
90077-2710
US

V. Phone/Fax

Practice location:
  • Phone: 310-738-8878
  • Fax:
Mailing address:
  • Phone: 310-738-8878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175L00000X
TaxonomyHomeopath
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: