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General NPI Number Information
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NPI Number | 1740462910
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Entity Type | Organization
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Legal Business Name | MICHAEL H. SIMONS D.P.M. A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 11/29/2007
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Last Update Date | 10/28/2010
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Provider Practice Location Address
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Address Line | 18111 BROOKHURST STREET SUITE 3400
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-6728
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Country | US
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Telephone | 714-861-4630
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Fax | 714-861-4631
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Provider Business Mailing Address
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Address Line | 18111 BROOKHURST ST SUITE 3400
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-6728
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Country | US
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Telephone | 714-861-4630
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Fax | 714-861-4631
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL HOWARD SIMONS
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Credential | D.P.M.
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Telephone | 714-861-4630
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E1388
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License Number State | CA
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