MEDICARE: DR. STEPHEN SIM DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	E4172	CA

Other Identifiers

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

General Provider Information

NPI Number	:	1285653808
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN SIM DPM

Provider Business Mailing Address
First Line	:	3130 W OLYMPIC BLVD
Second Line	:	SUITE 170
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-2484
Country	:	US
Telephone Number	:	323-732-7551
Fax Number	:	323-732-7829

Provider Business Practice Location Address
First Line	:	3130 W OLYMPIC BLVD
Second Line	:	SUITE 170
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-2484
Country	:	US
Telephone Number	:	323-732-7551
Fax Number	:	323-732-7829

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. STEPHEN SIM DPM” Practice Location

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