MEDICARE: DR. MATTHEW HURD PHD, DDS

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	1223D0004X	Dental Anesthesiology	DDS104217	CA

General Provider Information

NPI Number	:	1962961094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW HURD PHD, DDS

Provider Business Mailing Address
First Line	:	450 FOLSOM ST APT 1702
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94105-3373
Country	:	US
Telephone Number	:	310-868-4488
Fax Number	:

Provider Business Practice Location Address
First Line	:	450 FOLSOM ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94105-3172
Country	:	US
Telephone Number	:	310-868-4488
Fax Number	:

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

Provider Enumeration Date	:	03/18/2019
Last Update Date	:	01/23/2025

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