Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | G86007 | CA |
NPI | 1336259779 |
---|---|
Provider Name | Dr. Andrew James Matthews |
First Address | Gilroy, CA 95020-4943 |
Second Address | Gilroy, CA 95020-4943 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 26/07/2010 |