Provider Demographics
NPI:1356843973
Name:HOMAYOUN SIMAN APC
Entity Type:Organization
Organization Name:HOMAYOUN SIMAN APC
Other - Org Name:HOMAYOUN SIMAN APC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:HOMAYOUN
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-791-9004
Mailing Address - Street 1:73211 FRED WARING DR STE 101
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-2888
Mailing Address - Country:US
Mailing Address - Phone:760-837-0321
Mailing Address - Fax:626-791-9005
Practice Address - Street 1:73211 FRED WARING DR STE 101
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-2888
Practice Address - Country:US
Practice Address - Phone:760-837-0321
Practice Address - Fax:626-791-9005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-28
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA140616207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty