Healthcare Provider Details

I. General information

NPI: 1205900511
Provider Name (Legal Business Name): NOAH B. SIMONS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 03/31/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3641 SACRAMENTO ST SUITE A
SAN FRANCISCO CA
94118-1722
US

IV. Provider business mailing address

3641 SACRAMENTO ST SUITE A
SAN FRANCISCO CA
94118-1722
US

V. Phone/Fax

Practice location:
  • Phone: 415-601-1339
  • Fax:
Mailing address:
  • Phone: 415-601-1339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA91731
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: