Provider Demographics
NPI:1780881797
Name:SIMZAR, SOHEIL (MD)
Entity type:Individual
Prefix:
First Name:SOHEIL
Middle Name:
Last Name:SIMZAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2021 SANTA MONICA BLVD
Mailing Address - Street 2:SUITE 600E
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2208
Mailing Address - Country:US
Mailing Address - Phone:310-828-2282
Mailing Address - Fax:310-828-8504
Practice Address - Street 1:2021 SANTA MONICA BLVD
Practice Address - Street 2:SUITE 600E
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2208
Practice Address - Country:US
Practice Address - Phone:310-828-2282
Practice Address - Fax:310-828-8504
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA97769207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology