# SIMONIAN SPORTS MEDICINE CLINIC A MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942262555
- **Authorized official:** PETER T SIMONIAN M.D. (PRESIDENT)
- **Authorized official phone:** (559) 228-4204

## Contact information

- **Practice address:** 729 NORTH MEDICAL CENTER DRIVE WEST, SUITE 101, CLOVIS, CA 93611-6880
- **Practice address phone:** (559) 439-7633
- **Practice address fax:** (559) 439-7631
- **Mailing address:** PO BOX 28921, FRESNO, CA 93729-8921
- **Mailing address phone:** (559) 228-5448
- **Mailing address fax:** (559) 224-3920

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | G83773 | CA | Yes |

## Other

- **Enumeration date:** 04/06/2006
- **Last updated:** 08/13/2013