Provider Demographics
NPI:1710012695
Name:SIMPSON, LOUIS CLAYTON JR (MD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:CLAYTON
Last Name:SIMPSON
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:4572 DON MILAGRO DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008-2834
Mailing Address - Country:US
Mailing Address - Phone:323-298-0273
Mailing Address - Fax:323-299-1273
Practice Address - Street 1:3756 SANTA ROSALIA DR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90008-3606
Practice Address - Country:US
Practice Address - Phone:323-299-1262
Practice Address - Fax:323-299-1273
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA257942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA257940Medicaid
CA56402OtherBOARD CERTIFICATION
CA56402OtherBOARD CERTIFICATION
CA00A257940Medicare ID - Type Unspecified