Individual
CHARLES LEWIS SIMS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
351 N MTN VIEW AVE, SAN BERNARDINO, CA 92415-0010
(909) 387-6222
(909) 387-6228
Mailing address
1 GOLDEN SHR, MOLINA MEDICAL CENTERS SMO, LONG BEACH, CA 90802-4202
(909) 624-4952
(909) 621-9498
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
PA10600
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA10600
MEDI-CAL
CA
Enumeration date
07/03/2006
Last updated
02/07/2017
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