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General NPI Number Information
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NPI Number | 1487047981
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Entity Type | Organization
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Legal Business Name | HERBERT J. SIMONS, MD
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Dates
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Enumeration Date | 03/09/2015
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Last Update Date | 03/09/2015
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Provider Practice Location Address
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Address Line | 2650 E IMPERIAL HWY SUITE 202
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City | BREA
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State | CA
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Zip | 92821-6103
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Country | US
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Telephone | 714-524-3054
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Fax | 714-524-3094
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Provider Business Mailing Address
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Address Line | 10520 WHIPPLE ST
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City | TOLUCA LAKE
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State | CA
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Zip | 91602-2838
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Country | US
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Telephone | 303-807-5972
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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. HERBERT J SIMONS
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Credential | MD
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Telephone | 303-807-5972
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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 | C28351
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License Number State | CA
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