Healthcare Provider Details

I. General information

NPI: 1750461661
Provider Name (Legal Business Name): JOSEPH MOORE MATTHEWS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 03/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 GOVERNORS LANE SUITE A
CHICO CA
95926
US

IV. Provider business mailing address

2 GOVERNORS LANE SUITE A
CHICO CA
95926
US

V. Phone/Fax

Practice location:
  • Phone: 530-891-4523
  • Fax: 530-891-5934
Mailing address:
  • Phone: 530-891-4523
  • Fax: 530-891-5934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberG32836
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License NumberG32836
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: