Provider Demographics
NPI:1376272344
Name:KEVIN SIMONSON MD INC
Entity Type:Organization
Organization Name:KEVIN SIMONSON MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMONSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-230-2291
Mailing Address - Street 1:17800 WOODRUFF AVE STE B
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-7080
Mailing Address - Country:US
Mailing Address - Phone:949-230-2291
Mailing Address - Fax:
Practice Address - Street 1:3201 WILSHIRE BLVD STE 211
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-2337
Practice Address - Country:US
Practice Address - Phone:323-283-9998
Practice Address - Fax:434-204-5689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-06
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Single Specialty