Organization
NICHOLAS D. SIMOPOULOS MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS DEMETRIOS SIMOPOULOS MD (PRESIDENT)
(530) 626-1277
Entity
Organization
Contact information
Practice address
1000 FOWLER WAY STE 5, PLACERVILLE, CA 95667-5738
(530) 626-1277
(530) 626-3265
Mailing address
1000 FOWLER WAY STE 5, PLACERVILLE, CA 95667-5738
(530) 626-1277
(530) 626-3265
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DG7616
MEDICARE RAILROAD GROUP NUMBER
CA
Enumeration date
09/26/2006
Last updated
06/18/2008
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