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General NPI Number Information
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NPI Number | 1497970875
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Entity Type | Organization
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Legal Business Name | ADVANCED GASTROENTEROLOGY, INC.
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 555 MARIN ST STE 270
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-4112
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Country | US
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Telephone | 805-719-0244
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Fax | 805-777-1730
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Provider Business Mailing Address
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Address Line | 555 MARIN ST STE 270
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-4112
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Country | US
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Telephone | 805-719-0244
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Fax | 805-777-1730
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Authorized Official
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Title or Position | OWNER
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Name | DR. GILBERT SIMONI
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Credential | MD
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Telephone | 805-719-0244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | A77140
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License Number State | CA
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