| Kevin Simonson Md Inc | |
|
3201 Wilshire Blvd Ste 211 Santa Monica CA 90403-2337 | |
| (323) 283-9998 | |
| (434) 204-5689 |
| Full Name | Kevin Simonson Md Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3201 Wilshire Blvd Ste 211, Santa Monica, California |
| Authorized Official Name and Position | Kevin Simonson (PSYCHIATRIST) |
| Authorized Official Contact | 9492302291 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kevin Simonson Md Inc 17800 Woodruff Ave Ste B Bellflower CA 90706-7080 Ph: (949) 230-2291 | Kevin Simonson Md Inc 3201 Wilshire Blvd Ste 211 Santa Monica CA 90403-2337 Ph: (323) 283-9998 |
| NPI Number | 1376272344 |
|---|---|
| Provider Enumeration Date | 06/06/2022 |
| Last Update Date | 11/18/2022 |
| Certification Date | 11/18/2022 |
| Medicare PECOS PAC ID | 3779966783 |
|---|---|
| Medicare Enrollment ID | O20220823003326 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376272344 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Kevin Simonson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104349190 PECOS PAC ID: 4688057698 Enrollment ID: I20220823003453 |
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