Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 129685 | CA |
Y | 208600000X | Surgeon | 129685 | CA |
N | 2082S0105X | Plastic Hand Surgeon | 129685 | CA |
NPI | 1659790376 |
---|---|
Provider Name | Dr. Matthew Mcrae |
First Address | San Francisco, CA 94114-1019 |
Second Address | San Francisco, CA 94114-1019 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2014 |
Last Update Date | 08/07/2014 |