IVAN ANDRO SIMUNOVIC (NPI# 1275050999) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275050999 |
| Entity Type | Individual |
| Full Name | IVAN ANDRO SIMUNOVIC |
| Practice Address |
1341 Brookdale Ave. La Habra CA 90631 |
| Mailing Address |
1341 Brookdale Ave La Habra CA 90631-3221 |
| Practice Telephone | 5624410677 |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2017-08-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1341 BROOKDALE AVE. |
| City | LA HABRA |
| State | CA |
| Zip Code | 90631 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174163323 | Knowledge of Autism & Other Developmental Disabilities, LLC. | Assistant Behavior Analyst | 890 Whitebook Drive, La Habra, CA 90631 | 2020-01-15 |
| 1215572417 | Anthony Alonzo Favot | Physician Assistant | 2500 Sidon Ave., La Habra, CA 90631 | 2019-11-12 |
| 1487123618 | Adrian Acosta Dds A Prof Dental Corp | Dentist | 901 W. Whittier Blvd, La Habra, CA 90631 | 2018-11-16 |
| 1669961587 | La Habra Villa, LLC | Assisted Living Facility | 1100 E.whittier Blvd, La Habra, CA 90631 | 2018-05-07 |
| 1679089767 | Alicia Igarta | Behavioral Analyst | 890 Whitebook Dr, La Habra, CA 90631 | 2017-12-27 |
| 1609386564 | Antoinette Marie Burgonio | Counselor | 820 Buena Vista Ave, La Habra, CA 90631 | 2017-10-05 |
| 1023527710 | Sharon Rose Stines | Counselor | 271 W. Imperial Hwy, Suite C, La Habra, CA 90631 | 2017-09-25 |
| 1730609645 | Lorraine Danielle Granado | Specialist/Technologist | 2301 Las Palomas Dr, La Habra Heights, CA 90631 | 2017-06-21 |
| 1649717844 | Marzieh Simonton | Nurse Practitioner | 921 Donnybrook Ave, La Habra, CA 90631 | 2017-01-25 |
| 1932562964 | Vista Community Clinic | Clinic/Center | 341 S. Hillcrest St., La Habra, CA 90631 | 2016-03-29 |
| Find all providers in zip 90631 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730711821 | Haeeun Kim | Physician Assistant | 1008 Las Lomas Dr Unit C, La Habra, CA 90631-2263 | 2020-02-07 |
| 1215572417 | Anthony Alonzo Favot | Physician Assistant | 2500 Sidon Ave., La Habra, CA 90631 | 2019-11-12 |
| 1265801989 | Mitch Corley Calmer | Physician Assistant | 1254 Pine Edge Dr, La Habra, CA 90631-8506 | 2015-09-23 |
| 1598198897 | Jose Dejesus Ruvalcaba | Physician Assistant | 813 E Francis Ave, La Habra, CA 90631-4003 | 2013-08-10 |
| 1871887299 | Vida Health Care P.C. | Physician Assistant | 202 W. La Habra Blvd., La Habra, CA 90631 | 2011-06-02 |
| 1285010322 | Jonathan Joseph Tan | Physician Assistant | 1040 W Imperial Hwy Ste D, La Habra, CA 90631-0608 | 2015-07-30 |
| 1083016125 | Valerie Bonilla | Physician Assistant | 1040 W Imperial Hwy, La Habra, CA 90631-0608 | 2014-09-19 |
| 1073794152 | Esther Guardado | Physician Assistant | 501 S Idaho St, 100, La Habra, CA 90631 | 2007-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902407679 | Samantha Sidney Spinner | Physician Assistant | 1385 Shattuck Ave Apt 201, Berkeley, CA 94709-1468 | 2020-11-08 |
| 1134720972 | Alessandra Porfido | Physician Assistant | 733 Filbert St Apt 1, San Francisco, CA 94133-2767 | 2020-11-06 |
| 1992306872 | Kelsey Oberg | Physician Assistant | 1817 Oldfield Ct, El Cajon, CA 92019-4233 | 2020-11-05 |
| 1609477504 | Julia Claire Stiefel | Physician Assistant | 369 Orange St Apt A, Oakland, CA 94610-2979 | 2020-11-05 |
| 1164023347 | Wendy P Lewis | Physician Assistant | 10447 Highdale St, Bellflower, CA 90706-4122 | 2020-11-04 |
| 1245830181 | Lauren Bennett | Physician Assistant | 3360 Horizon St, Corona, CA 92881-0728 | 2020-10-29 |
| 1538769062 | Revital Ahl | Physician Assistant | 18141 Medley Dr, Encino, CA 91316-4447 | 2020-10-26 |
| 1922607423 | Emily Halla | Physician Assistant | 7473 Gresham Ct, San Jose, CA 95139-1424 | 2020-10-26 |
| 1386243889 | Ilaitia Lecia Namatasere | Physician Assistant | 614 Sycamore Ln Apt 225, Davis, CA 95616-7901 | 2020-10-26 |
| 1083213706 | Courtney Kathryn Hopp | Physician Assistant | 4060 Fourth Ave Ste 209, San Diego, CA 92103-2120 | 2020-10-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.