Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 20A7777 | CA |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 20A7777 | CA |
N | 207XS0117X | Orthopaedic Spine Surgeon | 20A7777 | CA |
N | 207XX0801X | Orthopaedic Trauma Surgeon | 20A7777 | CA |
NPI | 1124120092 |
---|---|
Provider Name | Simon Lavi |
First Address | Downey, CA 90242-3469 |
Second Address | Downey, CA 90242-3469 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2006 |
Last Update Date | 08/07/2007 |