Organization
SIMI RADIOLOGY AND IMAGING MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC CORDES M.D. (MANAGING PARTNER)
(805) 955-6360
Entity
Organization
Contact information
Practice address
2975 SYCAMORE DR, SIMI VALLEY, CA 93065-1201
(805) 955-6360
Mailing address
4100 GUARDIAN ST STE 205, SIMI VALLEY, CA 93063-6721
(805) 522-5940
(805) 522-6401
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CO8000
RAILROAD MEDICARE
—
05
—
GR0050170
—
CA
05
—
GR0050171
—
CA
01
—
ZZZ30810Z
BLUE SHIELD
—
01
—
ZZZ34708Z
BLUE SHIELD
—
Enumeration date
05/18/2006
Last updated
06/03/2015
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