Provider Demographics
NPI:1598771834
Name:SIMONIAN, SIMON K (MD)
Entity Type:Individual
Prefix:DR
First Name:SIMON
Middle Name:K
Last Name:SIMONIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:7080 HOLLYWOOD BLVD STE 919
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-6936
Mailing Address - Country:US
Mailing Address - Phone:323-462-2092
Mailing Address - Fax:323-462-8862
Practice Address - Street 1:7080 HOLLYWOOD BLVD STE 919
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90028-6936
Practice Address - Country:US
Practice Address - Phone:323-462-2092
Practice Address - Fax:323-462-8862
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC39045173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine