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General NPI Number Information
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NPI Number | 1093953705
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Entity Type | Organization
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Legal Business Name | STEVEN J SIMPSON O D AND BRADLEY N SIROIS O D PTRS
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Dates
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Enumeration Date | 02/03/2009
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Last Update Date | 04/22/2015
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Provider Practice Location Address
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Address Line | 40680 CALIFORNIA OAKS RD STE 1A
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City | MURRIETA
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State | CA
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Zip | 92562-5755
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Country | US
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Telephone | 951-600-1114
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Fax | 951-600-1242
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Provider Business Mailing Address
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Address Line | 40680 CALIFORNIA OAKS RD STE 1A
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City | MURRIETA
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State | CA
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Zip | 92562-5755
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Country | US
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Telephone | 951-600-1114
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Fax | 951-600-1242
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Authorized Official
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Title or Position | OWNER
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Name | STEVEN J SIMPSON
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Credential | OD
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Telephone | 951-600-1114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 9361T
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License Number State | CA
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