Healthcare Provider Details

I. General information

NPI: 1528376977
Provider Name (Legal Business Name): ZAKEE SALEEM MATTHEWS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2010
Last Update Date: 09/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 TAMALPAIS RD
BERKELEY CA
94708-1947
US

IV. Provider business mailing address

190 TAMALPAIS RD
BERKELEY CA
94708-1947
US

V. Phone/Fax

Practice location:
  • Phone: 510-649-9008
  • Fax: 510-649-9008
Mailing address:
  • Phone: 510-649-9008
  • Fax: 510-649-9008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA49182
License Number StateCA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: