SIMI VALLEY CENTER FOR PLASTIC SURGERY NPI 1053428409

NPI Information

  • NPI: 1053428409
  • Provider Name: SIMI VALLEY CENTER FOR PLASTIC SURGERY
  • Classification: Plastic Surgery - 2082S0105X
  • Specialization: Surgery of the Hand
  • Entity Type: Organization
  • Address: 2750 SYCAMORE DR STE 200
    SIMI VALLEY, CA
    ZIP 93065
  • Phone: (805) 579-0821

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NPI Details

SIMI VALLEY CENTER FOR PLASTIC SURGERY is a surgery of the hand plastic surgery in Simi Valley, CA. The provider is a plastic surgeon with additional training in the investigation, preservation, and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist. SIMI VALLEY CENTER FOR PLASTIC SURGERY NPI is 1053428409. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2750 SYCAMORE DR STE 200
SIMI VALLEY, CA
ZIP 93065-500
Phone: (805) 579-0821
Fax: (805) 579-0879

The provider's authorized official is Michael James Fealy .
The authorized official title is President and has the following contact phone number (805) 579-0821.

The enumeration date for this NPI number is 8/23/2006 and was last updated on 11/6/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208200000XPlastic SurgeryNo
22082S0105XPlastic SurgerySurgery of the HandYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1W18236MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA
2F16274MEDICARE UPINCALIFORNIA

What is NPI?

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This page was last updated on: 3/30/2025

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