Healthcare Provider Details

I. General information

NPI: 1417267766
Provider Name (Legal Business Name): JOSEPH M MATTHEWS MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2010
Last Update Date: 02/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 GOVERNORS LN STE A
CHICO CA
95926-1988
US

IV. Provider business mailing address

2 GOVERNORS LN STE A
CHICO CA
95926-1988
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 TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License NumberG32836
License Number StateCA

VIII. Authorized Official

Name: JOSEPH M MATTHEWS
Title or Position: MD/PRESIDENT
Credential: MD
Phone: 530-891-4523