Provider Demographics
NPI:1871810374
Name:STEPHAN SIMONIAN MD APC
Entity type:Organization
Organization Name:STEPHAN SIMONIAN MD APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMONIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-551-1118
Mailing Address - Street 1:1141 N BRAND BLVD
Mailing Address - Street 2:SUITE # 306
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-2511
Mailing Address - Country:US
Mailing Address - Phone:818-551-1118
Mailing Address - Fax:818-551-1955
Practice Address - Street 1:1141 N BRAND BLVD
Practice Address - Street 2:SUITE # 306
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202-2511
Practice Address - Country:US
Practice Address - Phone:818-551-1118
Practice Address - Fax:818-551-1955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-23
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty