Provider Demographics
NPI:1053510834
Name:SIMPSON, MILICA E (MD)
Entity Type:Individual
Prefix:DR
First Name:MILICA
Middle Name:E
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23815 STUART RANCH RD STE 300
Mailing Address - Street 2:
Mailing Address - City:MALIBU
Mailing Address - State:CA
Mailing Address - Zip Code:90265-4861
Mailing Address - Country:US
Mailing Address - Phone:310-456-1668
Mailing Address - Fax:310-456-8838
Practice Address - Street 1:23815 STUART RANCH RD STE 300
Practice Address - Street 2:
Practice Address - City:MALIBU
Practice Address - State:CA
Practice Address - Zip Code:90265-4861
Practice Address - Country:US
Practice Address - Phone:310-456-1668
Practice Address - Fax:310-456-8838
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-12
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA107419207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics