Healthcare Provider Details

I. General information

NPI: 1942283221
Provider Name (Legal Business Name): ROBERT DAVID SIMENSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DAVID SIMENSON MD

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 03/07/2023
Certification Date: 03/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

847 W CHILDS AVE
MERCED CA
95341-6862
US

IV. Provider business mailing address

737 W CHILDS AVE
MERCED CA
95340-6805
US

V. Phone/Fax

Practice location:
  • Phone: 866-682-4842
  • Fax:
Mailing address:
  • Phone: 209-383-1848
  • Fax: 209-383-1296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberC41324
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberC41327
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: