Individual
SIMON JIANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
925 S ATLANTIC BLVD STE 106, MONTEREY PARK, CA 91754-4734
(213) 458-3132
(213) 234-4542
Mailing address
1335 S SAN GABRIEL BLVD, SAN MARINO, CA 91108-2703
(213) 458-3132
(213) 234-4542
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A69991
CA
208D00000X
General Practice Physician
Primary
A69991
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A699910
—
CA
05
—
00A699911
—
CA
Enumeration date
05/19/2006
Last updated
04/26/2019
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