Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A94925 | CA |
N | 111NI0900X | Internist | A94925 | CA |
N | 207RC0000X | Internist - Cardiovascular Disease | A94925 | CA |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | A94925 | CA |
NPI | 1205033073 |
---|---|
Provider Name | Dr. Matthew Phillip Ostrom |
First Address | Torrance, CA 90505-5116 |
Second Address | Torrance, CA 90505-5116 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2007 |
Last Update Date | 08/03/2017 |