Provider Demographics
NPI:1255354486
Name:SIMI SURGERY CENTER INC.
Entity type:Organization
Organization Name:SIMI SURGERY CENTER INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:NURSE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:K
Authorized Official - Last Name:BOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:RN CNOR
Authorized Official - Phone:805-306-8800
Mailing Address - Street 1:1920 E. LOS ANGELES AVE.
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-3505
Mailing Address - Country:US
Mailing Address - Phone:805-306-8800
Mailing Address - Fax:805-306-8809
Practice Address - Street 1:1920 E. LOS ANGELES AVE.
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-3505
Practice Address - Country:US
Practice Address - Phone:805-306-8800
Practice Address - Fax:805-306-8809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPENDINGMedicare ID - Type Unspecified