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General NPI Number Information
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NPI Number | 1184925141
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Entity Type | Organization
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Legal Business Name | SIMONMED IMAGING A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 11/08/2010
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Last Update Date | 03/24/2014
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Provider Practice Location Address
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Address Line | 400 CHANNING AVE
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City | PALO ALTO
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State | CA
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Zip | 94301-2801
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Country | US
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Telephone | 650-323-1343
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Fax | 650-323-1352
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Provider Business Mailing Address
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Address Line | PO BOX 51227
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City | LOS ANGELES
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State | CA
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Zip | 90051-5527
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Country | US
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Telephone | 888-685-3909
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Fax | 800-508-4751
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HOWARD J SIMON
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Credential | M.D.
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Telephone | 480-809-4829
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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