Individual
SHILOH A SIMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3075 HEALTH CENTER DR STE 403, SAN DIEGO, CA 92123-2773
(858) 278-9900
Mailing address
75 ENTERPRISE STE 200, ALISO VIEJO, CA 92656-2626
(949) 554-4688
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
20A17687
CA
207W00000X
Ophthalmology Physician
46954
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43516000
—
WI
Enumeration date
02/28/2007
Last updated
06/17/2020
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