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General NPI Number Information
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NPI Number | 1386770865
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Entity Type | Organization
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Legal Business Name | LAWRENCE G. SIMONS
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4505 LAS VIRGENES RD #106
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City | CALABASAS
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State | CA
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Zip | 91302-1956
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Country | US
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Telephone | 818-871-9898
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Fax | 818-871-9797
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Provider Business Mailing Address
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Address Line | 4505 LAS VIRGENES RD #106
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City | CALABASAS
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State | CA
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Zip | 91302-1956
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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 | OWNER
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Name | DR. LAWRENCE GLENN SIMONS
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Credential | O.D.
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Telephone | 818-871-9898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number | 7352T
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License Number State | CA
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