Provider Demographics
NPI:1659335156
Name:SIMJEE, AISHA (MD)
Entity type:Individual
Prefix:
First Name:AISHA
Middle Name:
Last Name:SIMJEE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 CANYON TER
Mailing Address - Street 2:
Mailing Address - City:NEWPORT COAST
Mailing Address - State:CA
Mailing Address - Zip Code:92657-1700
Mailing Address - Country:US
Mailing Address - Phone:714-771-2022
Mailing Address - Fax:714-860-4100
Practice Address - Street 1:15 CANYON TER
Practice Address - Street 2:
Practice Address - City:NEWPORT COAST
Practice Address - State:CA
Practice Address - Zip Code:92657-1700
Practice Address - Country:US
Practice Address - Phone:714-771-2022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-13
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA174400000X
174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA31457Medicare ID - Type Unspecified
CAA26491Medicare UPIN