Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 50098 | CA |
NPI | 1013306430 |
---|---|
Provider Name | Dr. Harel Simon |
First Address | Beverly Hills, CA 90210-4322 |
Second Address | Beverly Hills, CA 90210-4322 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2015 |
Last Update Date | 22/01/2015 |