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Individual

MR. CARLOS SIMON USMANY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
1704 W MANCHESTER AVE STE 101, LOS ANGELES, CA 90047-3056
(323) 778-6215
(323) 778-6312
Mailing address
1704 W MANCHESTER AVE STE 101, LOS ANGELES, CA 90047-3056
(323) 778-6215
(323) 778-6312

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA15730
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA 15703
PHYSICIAN ASSISTANT COMMI
CA
Enumeration date
02/04/2008
Last updated
02/04/2008
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