Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | G79837 | CA |
NPI | 1588735476 |
---|---|
Provider Name | Erin Jessica Simms |
First Address | Oakland, CA 94609-1810 |
Second Address | Oakland, CA 94609-1810 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 24/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G798370 | (05) | CA |