Healthcare Provider Details

I. General information

NPI: 1235028036
Provider Name (Legal Business Name): SIMPLIFED MEDICAL CA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2025
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16380 ROSCOE BLVD STE 100
VAN NUYS CA
91406-1221
US

IV. Provider business mailing address

9615 E COUNTY LINE RD # STB
CENTENNIAL CO
80112-3527
US

V. Phone/Fax

Practice location:
  • Phone: 888-991-6772
  • Fax:
Mailing address:
  • Phone: 888-991-6772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ALEC MACAULAY
Title or Position: PRESIDENT
Credential: MD
Phone: 339-234-0164