Healthcare Provider Details

I. General information

NPI: 1871682096
Provider Name (Legal Business Name): SIMI HEALTH CENTER A MEDICAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 11/15/2022
Certification Date: 11/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 E LOS ANGELES AVE
SIMI VALLEY CA
93065-2898
US

IV. Provider business mailing address

1350 E LOS ANGELES AVE
SIMI VALLEY CA
93065-2898
US

V. Phone/Fax

Practice location:
  • Phone: 805-522-3782
  • Fax: 805-522-1283
Mailing address:
  • Phone: 805-522-3782
  • Fax: 805-522-1283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHANDRASHEKHAR R JOSHI
Title or Position: MD/OWNER
Credential:
Phone: 805-522-3782