Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 20A12102 | CA |
NPI | 1306077870 |
---|---|
Provider Name | Dr. Matthew Douglas Pugh |
First Address | Chula Vista, CA 91911-6654 |
Second Address | Chula Vista, CA 91911-6654 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2009 |
Last Update Date | 08/07/2013 |