Organization
SIMONMED IMAGING A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOWARD J SIMON M.D. (PRESIDENT)
(480) 809-4829
Entity
Organization
Contact information
Practice address
400 CHANNING AVE, PALO ALTO, CA 94301-2801
(650) 323-1343
(650) 323-1352
Mailing address
PO BOX 51227, LOS ANGELES, CA 90051-5527
(888) 685-3909
(800) 508-4751
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DR1583
RAILROAD MEDICARE
—
01
—
ZZZ65588Y
BLUE SHIELD OF CA
CA
01
—
ZZZ65588Y
BLUE SHIELD
—
01
—
ZZZ66173Y
BLUE SHIELD
—
01
—
ZZZ67346Y
BLUE SHIELD
—
01
—
ZZZ67347Y
BLUE SHIELD
—
01
—
ZZZ67572Y
BLUE SHIELD
—
01
—
ZZZ68489Y
BLUE SHIELD
—
01
—
ZZZ69174Y
BLUE SHIELD
—
01
—
ZZZ69391Y
BLUE SHIELD
—
01
—
ZZZ69392Y
BLUE SHIELD
—
Enumeration date
11/08/2010
Last updated
03/24/2014
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