Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 20A17818 | CA |
Y | 207QA0401X | Family Doctor - Addiction Medicine | 20A17818 | CA |
NPI | 1356835243 |
---|---|
Provider Name | Matthew Lamon |
First Address | Ventura, CA 93003-7307 |
Second Address | Ventura, CA 93003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2018 |
Last Update Date | 21/07/2021 |