Provider Demographics
NPI:1689473324
Name:SIMHAIRY, EDDIE LUAY
Entity type:Individual
Prefix:
First Name:EDDIE
Middle Name:LUAY
Last Name:SIMHAIRY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1759 SUNSET ROSE CT
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92019-3891
Mailing Address - Country:US
Mailing Address - Phone:619-760-3275
Mailing Address - Fax:
Practice Address - Street 1:1759 SUNSET ROSE CT
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92019-3891
Practice Address - Country:US
Practice Address - Phone:619-760-3275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program