Provider Demographics
NPI:1548384167
Name:SIMON, KAREN (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:
Last Name:SIMON
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:P.O. BOX 50640
Mailing Address - Street 2:VENTURA COUNTY GASTROENTEROLOGY
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93031
Mailing Address - Country:US
Mailing Address - Phone:805-983-0521
Mailing Address - Fax:805-485-1484
Practice Address - Street 1:2241 WANKEL WAY
Practice Address - Street 2:SUITE A
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030
Practice Address - Country:US
Practice Address - Phone:805-983-0521
Practice Address - Fax:805-485-1484
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA81831207RG0100X, 174400000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI24016Medicare UPIN