Provider Demographics
NPI:1568453264
Name:SIMS, STEPHEN JUSTIN (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:JUSTIN
Last Name:SIMS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:525 SOUTH DR STE 107
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-4211
Mailing Address - Country:US
Mailing Address - Phone:650-386-0386
Mailing Address - Fax:650-386-0468
Practice Address - Street 1:525 SOUTH DR STE 107
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4211
Practice Address - Country:US
Practice Address - Phone:650-386-0386
Practice Address - Fax:650-386-0468
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG69269207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6283233Medicaid
CA00G692690Medicare ID - Type Unspecified
CA6283233Medicaid