Provider Demographics
NPI:1124120092
Name:LAVI, SIMON (DO)
Entity type:Individual
Prefix:
First Name:SIMON
Middle Name:
Last Name:LAVI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7700 IMPERIAL HWY
Mailing Address - Street 2:SUITE R
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242-3469
Mailing Address - Country:US
Mailing Address - Phone:562-803-0600
Mailing Address - Fax:562-803-5040
Practice Address - Street 1:7700 IMPERIAL HWY
Practice Address - Street 2:SUITE R
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-3469
Practice Address - Country:US
Practice Address - Phone:562-803-0600
Practice Address - Fax:562-803-5040
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A7777207X00000X, 207XS0114X, 207XS0117X, 207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Not Answered207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Not Answered207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Not Answered207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma