Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | A92539 | CA |
NPI | 1013018936 |
---|---|
Provider Name | Matthew Allen Musick |
First Address | San Francisco, CA 94109-7864 |
Second Address | Palo Alto, CA 94304-1503 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 08/07/2007 |