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General NPI Number Information
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NPI Number | 1285972299
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Entity Type | Organization
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Legal Business Name | GEORGE V SIMON, MD
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Dates
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Enumeration Date | 01/25/2013
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Last Update Date | 01/25/2013
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Provider Practice Location Address
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Address Line | 1390 WILLOW PASS RD SUITE 120
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City | CONCORD
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State | CA
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Zip | 94520-5200
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Country | US
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Telephone | 925-688-0400
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Fax | 925-688-0403
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Provider Business Mailing Address
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Address Line | 1390 WILLOW PASS RD SUITE 120
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City | CONCORD
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State | CA
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Zip | 94520-5200
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Country | US
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Telephone | 925-688-0400
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Fax | 925-688-0403
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Authorized Official
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Title or Position | PRESIDENT
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Name | GEORGE VICTOR SIMON
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Credential | MD
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Telephone | 925-688-0400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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License Number | G23786
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License Number State | CA
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