Provider Demographics
NPI:1922248657
Name:SIMMONS, TODD TYLER (MD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:TYLER
Last Name:SIMMONS
Suffix:
Gender:M
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:PO BOX 5010
Mailing Address - Street 2:PMB 132
Mailing Address - City:RANCHO SANTA FE
Mailing Address - State:CA
Mailing Address - Zip Code:92067-5010
Mailing Address - Country:US
Mailing Address - Phone:949-842-2295
Mailing Address - Fax:949-842-2295
Practice Address - Street 1:2185 CITRACADO PARKWAY
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92029
Practice Address - Country:US
Practice Address - Phone:442-281-1072
Practice Address - Fax:760-480-0186
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-20
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA106863207P00000X
146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty