Healthcare Provider Details

I. General information

NPI: 1841343548
Provider Name (Legal Business Name): MATTHEW JOAQUIN DI FRANCO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 12/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 EUCLID AVE STE 202
NATIONAL CITY CA
91950-2985
US

IV. Provider business mailing address

PO BOX 436484
SAN YSIDRO CA
92143-6484
US

V. Phone/Fax

Practice location:
  • Phone: 619-267-1022
  • Fax: 619-267-5680
Mailing address:
  • Phone: 619-290-8744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG58994
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: