Healthcare Provider Details

I. General information

NPI: 1548384167
Provider Name (Legal Business Name): KAREN SIMON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 12/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2241 WANKEL WAY SUITE A
OXNARD CA
93030
US

IV. Provider business mailing address

P.O. BOX 50640 VENTURA COUNTY GASTROENTEROLOGY
OXNARD CA
93031
US

V. Phone/Fax

Practice location:
  • Phone: 805-983-0521
  • Fax: 805-485-1484
Mailing address:
  • Phone: 805-983-0521
  • Fax: 805-485-1484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberA81831
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA81831
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA81831
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: