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Individual
DR. PETER JOHN SIMIC JR.
Active
Individual
DR. PETER JOHN SIMIC JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G78807
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G504290
BLUE SHIELD
—
01
—
00G788070
BLUE SHIELD
CA
05
—
00G788070
—
CA
01
—
G50429
BLUE CROSS
—
01
—
G78807
BLUE CROSS
CA
Enumeration date
05/26/2006
Last updated
09/20/2012
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