MEDICARE: DR. MATTHEW THOMAS JUAREZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	196188	CA

General Provider Information

NPI Number	:	1942880216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW THOMAS JUAREZ M.D.

Provider Business Mailing Address
First Line	:	1200 N STATE STREET CLINIC TOWER
Second Line	:	SUITE A7D
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-1029
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 N STATE STREET CLINIC TOWER
Second Line	:	SUITE A7D
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-1029
Country	:	US
Telephone Number	:	323-409-7556
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2021
Last Update Date	:	05/30/2026

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