Provider Demographics
NPI:1467743864
Name:SIMARD, TAMI JANE (DO)
Entity Type:Individual
Prefix:DR
First Name:TAMI
Middle Name:JANE
Last Name:SIMARD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:TAMI
Other - Middle Name:JANE
Other - Last Name:ROLLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1290 CALLE YUCCA
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-2239
Mailing Address - Country:US
Mailing Address - Phone:310-634-9767
Mailing Address - Fax:
Practice Address - Street 1:3180 WILLOW LN STE 200
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91361
Practice Address - Country:US
Practice Address - Phone:805-497-3239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-20
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A12553207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty