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General NPI Number Information
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NPI Number | 1114737798
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Entity Type | Individual
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Provider Name | YEVGENYA SIMONYAN
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Gender | Female
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Dates
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Enumeration Date | 01/07/2025
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 11240 MAGNOLIA BLVD STE 102
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91601-3790
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Country | US
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Telephone | 747-877-8184
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Fax |
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Provider Business Mailing Address
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Address Line | 1630 SHADOW OAKS PL
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City | THOUSAND OAKS
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State | CA
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Zip | 91362-1925
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | NP95033139
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License Number State | CA
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