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General NPI Number Information
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NPI Number | 1861692600
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Entity Type | Organization
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Legal Business Name | JOHN B SIMONDS M.D., INC.
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Dates
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Enumeration Date | 07/19/2007
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Last Update Date | 07/19/2007
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Provider Practice Location Address
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Address Line | 231 W VERNON AVE 204
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City | LOS ANGELES
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State | CA
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Zip | 90037-2700
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Country | US
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Telephone | 323-521-1544
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Fax | 323-521-1546
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Provider Business Mailing Address
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Address Line | 231 W VERNON AVE 204
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City | LOS ANGELES
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State | CA
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Zip | 90037-2700
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Country | US
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Telephone | 323-521-1544
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Fax | 323-521-1546
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Authorized Official
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Title or Position | OWNER /MD
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Name | DR. JOHN B SIMONDS
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Credential | M.D.
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Telephone | 323-521-1544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | G77483
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License Number State | CA
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