Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OPT13337 | CA |
NPI | 1013117068 |
---|---|
Provider Name | Dr. Brett Elliot Simon |
First Address | Santa Barbara, CA 93160-2106 |
Second Address | Santa Barbara, CA 93101-3149 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2007 |
Last Update Date | 17/10/2013 |