Healthcare Provider Details

I. General information

NPI: 1083623664
Provider Name (Legal Business Name): SIMA ASADI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 OLIVEWOOD DR
MERCED CA
95348-1210
US

IV. Provider business mailing address

PO BOX 2896
MERCED CA
95344-0896
US

V. Phone/Fax

Practice location:
  • Phone: 209-383-3671
  • Fax: 209-383-4037
Mailing address:
  • Phone: 209-383-3671
  • Fax: 209-383-4037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA063923
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: