Provider Information for 1881972859
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LAURA SIMS
Sex: Female
NPI: 1881972859
Last Updated: 2024-11-25
Certification Date: 2024-11-25
Certification Date: 2024-11-25
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1881972859 | ||||||||||||
| Enumeration Date | 2011-07-25 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 2550 E RIVERSIDE DR APT 105 ONTARIO, CA 91761-7377 United States Phone: 424-757-7038 | Fax: | ||||||||||||
| Primary Practice Address | 8929 S SEPULVEDA BLVD STE 201 LOS ANGELES, CA 90045-3643 United States Phone: 310-645-5227 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 3634 ELIZABETH ST | ||||||||||||
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