Healthcare Provider Details
I. General information
NPI: 1275485385
Provider Name (Legal Business Name): SIMI VALLEY EMERGENCY PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/11/2026
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2975 SYCAMORE DR EMERGENCY DEPARTMENT
SIMI VALLEY CA
93065-1201
US
IV. Provider business mailing address
1509 WILSON TER EMERGENCY DEPARTMENT
GLENDALE CA
91206-4007
US
V. Phone/Fax
- Phone: 818-863-4366
- Fax:
- Phone: 818-863-4366
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ANTHONY
CARDILLO
Title or Position: CEO
Credential: MD
Phone: 310-488-2830