Healthcare Provider Details

I. General information

NPI: 1043176852
Provider Name (Legal Business Name): SIMI VALLEY RETINA SPECIALISTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/25/2025
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1687 ERRINGER RD STE 102
SIMI VALLEY CA
93065-6509
US

IV. Provider business mailing address

1687 ERRINGER RD STE 102
SIMI VALLEY CA
93065-6509
US

V. Phone/Fax

Practice location:
  • Phone: 805-330-1482
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number
License Number State

VIII. Authorized Official

Name: NIKA BAGHERI
Title or Position: OWNER/PHYSICIAN
Credential: MD
Phone: 818-292-0946