MEDICARE: SIMI VALLEY EMERGENCY PHYSICIANS

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
1	207P00000X	Emergency Medicine Physician

General Provider Information

NPI Number	:	1275485385
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIMI VALLEY EMERGENCY PHYSICIANS

Provider Business Mailing Address
First Line	:	1509 WILSON TER
Second Line	:	EMERGENCY DEPARTMENT
City	:	GLENDALE
State	:	CA
Zip	:	91206-4007
Country	:	US
Telephone Number	:	818-863-4366
Fax Number	:

Provider Business Practice Location Address
First Line	:	2975 SYCAMORE DR
Second Line	:	EMERGENCY DEPARTMENT
City	:	SIMI VALLEY
State	:	CA
Zip	:	93065-1201
Country	:	US
Telephone Number	:	818-863-4366
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. ANTHONY CARDILLO
Credential	:	MD
Telephone Number	:	310-488-2830

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	02/11/2026

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