Provider Demographics
NPI:1578641874
Name:ALB, SIMONA DANIELA (MD)
Entity Type:Individual
Prefix:DR
First Name:SIMONA
Middle Name:DANIELA
Last Name:ALB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:480 4TH AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-4410
Mailing Address - Country:US
Mailing Address - Phone:619-427-3361
Mailing Address - Fax:619-427-6821
Practice Address - Street 1:480 4TH AVE STE 202
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-4412
Practice Address - Country:US
Practice Address - Phone:619-427-3361
Practice Address - Fax:619-427-6821
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA98085207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1578641874Medicare PIN