MEDICARE: DR. STEPHEN JUSTIN SIMS 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
1	207Q00000X	Family Medicine Physician	G69269	CA

General Provider Information

NPI Number	:	1568453264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN JUSTIN SIMS MD

Provider Business Mailing Address
First Line	:	525 SOUTH DR STE 107
Second Line	:
City	:	MOUNTAIN VIEW
State	:	CA
Zip	:	94040-4211
Country	:	US
Telephone Number	:	650-386-0386
Fax Number	:	650-386-0468

Provider Business Practice Location Address
First Line	:	525 SOUTH DR STE 107
Second Line	:
City	:	MOUNTAIN VIEW
State	:	CA
Zip	:	94040-4211
Country	:	US
Telephone Number	:	650-386-0386
Fax Number	:	650-386-0468

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

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	02/27/2025

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