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General NPI Number Information
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NPI Number | 1447387279
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Entity Type | Individual
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Provider Name | SHILOH A SIMONS DO
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Gender | Male
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 06/17/2020
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Provider Practice Location Address
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Address Line | 3075 HEALTH CENTER DR STE 403
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City | SAN DIEGO
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State | CA
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Zip | 92123-2773
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Country | US
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Telephone | 858-278-9900
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Fax |
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Provider Business Mailing Address
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Address Line | 75 ENTERPRISE STE 200
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City | ALISO VIEJO
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State | CA
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Zip | 92656-2626
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Country | US
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Telephone | 949-554-4688
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 46954
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 20A17687
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License Number State | CA
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