MEDICARE: SIMONA ALEXANDRA FIKHMAN

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	363AS0400X	Surgical Physician Assistant	51462	CA

General Provider Information

NPI Number	:	1477979656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIMONA ALEXANDRA FIKHMAN

Provider Business Mailing Address
First Line	:	3959 LAUREL CANYON BLVD
Second Line	:
City	:	STUDIO CITY
State	:	CA
Zip	:	91604-4921
Country	:	US
Telephone Number	:	818-505-9300
Fax Number	:

Provider Business Practice Location Address
First Line	:	3959 LAUREL CANYON BLVD
Second Line	:
City	:	STUDIO CITY
State	:	CA
Zip	:	91604-4921
Country	:	US
Telephone Number	:	818-505-9300
Fax Number	:

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

Provider Enumeration Date	:	03/11/2014
Last Update Date	:	10/14/2025

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