Healthcare Provider Details

I. General information

NPI: 1255354486
Provider Name (Legal Business Name): SIMI SURGERY CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 E. LOS ANGELES AVE.
SIMI VALLEY CA
93065-3505
US

IV. Provider business mailing address

1920 E. LOS ANGELES AVE.
SIMI VALLEY CA
93065-3505
US

V. Phone/Fax

Practice location:
  • Phone: 805-306-8800
  • Fax: 805-306-8809
Mailing address:
  • Phone: 805-306-8800
  • Fax: 805-306-8809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. CINDY K. BOYLE
Title or Position: NURSE MANAGER
Credential: RN CNOR
Phone: 805-306-8800