Individual
SIMON JOSEPH MADORSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
180 NEWPORT CENTER DR, 158, NEWPORT BEACH, CA 92660-6972
(949) 719-1800
(949) 719-1810
Mailing address
PO BOX 6765, ORANGE, CA 92863-6765
(714) 571-5000
(714) 571-5055
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
A50075
CA
207YS0123X
Facial Plastic Surgery Physician
A50075
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A500750
—
CA
01
—
P00002596
RAILROAD MEDICARE
—
01
—
P01404246
RAILROAD MEDICARE
—
Enumeration date
07/18/2005
Last updated
10/08/2015
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