Organization
SMI IMAGING, LLC
Active
Other names
SimonMed Imaging - Thunderbird II
Organization subpart
No
Provider details
NPI number
Authorized official
HOWARD J SIMON M.D. (PRESIDENT)
(480) 264-2400
Entity
Organization
Contact information
Practice address
5410 W THUNDERBIRD RD STE 221, GLENDALE, AZ 85306-4711
(602) 682-5000
(602) 682-5010
Mailing address
PO BOX 7368, ORANGE, CA 92863-7368
(714) 571-5000
(714) 571-5055
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
OTC4702
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
473411
—
AZ
01
—
P00811052
RAILROAD MEDICARE
—
Enumeration date
09/04/2009
Last updated
05/05/2011
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