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Individual
SIMON KANGAVARI
Active
Individual
SIMON KANGAVARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95-4170981
APEX CARDIOLOGY PROV ID
CA
01
—
A69521
MEDICAL LICENSE
CA
01
—
W10766
MEDICARE PROVIDER ID
CA
Enumeration date
06/30/2005
Last updated
12/08/2021
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