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General NPI Number Information
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NPI Number | 1245242742
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Entity Type | Individual
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Provider Name | ZIV SIMON D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9400 BRIGHTON WAY STE 311
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4710
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Country | US
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Telephone | 310-273-1900
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Fax | 310-247-2332
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Provider Business Mailing Address
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Address Line | 1607 GLENDON AVE APT 6
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City | LOS ANGELES
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State | CA
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Zip | 90024-6839
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Country | US
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Telephone | 310-470-8770
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Fax | 310-470-8770
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 50988
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License Number State | CA
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