Individual
SIMONE NICOLE BOECKMANN MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MPH
Contact information
Practice address
1200 N STATE STREET, GENERAL HOSPITAL, DERMATOLOGY - RM 3250, LOS ANGELES, CA 90033
(323) 409-3360
(323) 226-2654
Mailing address
1200 N STATE ST RM 3250, LOS ANGELES, CA 90089-1001
(323) 409-3360
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A180644
CA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/09/2020
Last updated
06/12/2023
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