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NPI Code Detail

MEDICARE: DR. SIMON R VALENCIA MD

MEDICARE: DR. SIMON R VALENCIA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RE0101XEndocrinology, Diabetes & Metabolism PhysicianA29972CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053476176
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SIMON R VALENCIA MD
Provider Business Mailing Address
First Line : PO BOX 29220
Second Line :
City : LOS ANGELES
State : CA
Zip : 90029-0220
Country : US
Telephone Number : 323-315-0911
Fax Number : 323-798-3021
Provider Business Practice Location Address
First Line : 6245 DE LONGPRE AVE
Second Line : FLR 2
City : LOS ANGELES
State : CA
Zip : 90028-8253
Country : US
Telephone Number : 323-315-0911
Fax Number : 323-798-3021
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/27/2006
Last Update Date : 03/05/2026

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