Provider Demographics
NPI:1770521312
Name:SIMPKINS, RUBY C (MD)
Entity type:Individual
Prefix:
First Name:RUBY
Middle Name:C
Last Name:SIMPKINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:RUBY
Other - Middle Name:CARROLL
Other - Last Name:SIMPKINS,INC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:28240 AGOURA RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-2485
Mailing Address - Country:US
Mailing Address - Phone:818-991-9800
Mailing Address - Fax:818-991-9814
Practice Address - Street 1:28240 AGOURA RD
Practice Address - Street 2:SUITE 201
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-2485
Practice Address - Country:US
Practice Address - Phone:818-991-9800
Practice Address - Fax:818-991-9814
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-04
Last Update Date:2008-02-22
Deactivation Date:2006-08-29
Deactivation Code:
Reactivation Date:2008-02-22
Provider Licenses
StateLicense IDTaxonomies
CAG31675207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA44836Medicare UPIN