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General NPI Number Information
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NPI Number | 1821105248
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Entity Type | Individual
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Provider Name | JONATHAN W SIMONS M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 10/22/2013
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Provider Practice Location Address
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Address Line | 1250 4TH ST SUITE 360
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City | SANTA MONICA
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State | CA
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Zip | 90401-1366
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Country | US
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Telephone | 310-570-4712
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Fax |
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Provider Business Mailing Address
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Address Line | 1250 4TH STREET SUITE 360
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City | SANTA MONICA
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State | CA
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Zip | 90401-1444
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Country | US
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Telephone | 310-570-4712
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 49370
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License Number State | GA
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