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Individual

CATHERINE FERGUSON SIMS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D

Contact information

Practice address
1117 E DEVONSHIRE AVE, HEMET, CA 92543-3083
(951) 929-6290
(951) 765-2855
Mailing address
PO BOX 788, HEMET, CA 92546-0788
(951) 929-6260
(951) 765-2855

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G37585
CA
207L00000X
Anesthesiology Physician
L4126
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
050089485
RAILROAD- MEDICARE
TX
01
1465798
LA- MEDICAID
LA
05
153681501
TX
01
8B7329
TX-BLUE SHIELD
01
G37585
CA LICENSE
CA
Enumeration date
01/18/2007
Last updated
12/17/2012
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