Provider Demographics
NPI:1972527885
Name:SIMON, ROBERT E (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:E
Last Name:SIMON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:27800 MEDICAL CENTER RD
Mailing Address - Street 2:SUITE 226
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6410
Mailing Address - Country:US
Mailing Address - Phone:949-364-9054
Mailing Address - Fax:949-364-6171
Practice Address - Street 1:27800 MEDICAL CENTER RD
Practice Address - Street 2:SUITE 226
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6410
Practice Address - Country:US
Practice Address - Phone:949-364-9054
Practice Address - Fax:949-364-6171
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2008-02-28
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Provider Licenses
StateLicense IDTaxonomies
CAG277022084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWG27702AMedicare PIN
CAA43453Medicare UPIN