Individual
LAUREN SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
25455 BARTON RD, SUITE 204B, LOMA LINDA, CA 92354-3128
(909) 558-6600
Mailing address
54701 FILE NUMBER, LOS ANGELES, CA 90074-4701
(909) 558-3111
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
G72126
CA
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
G72126
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G721260
—
CA
Enumeration date
07/17/2006
Last updated
11/09/2015
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