Healthcare Provider Details

I. General information

NPI: 1669448940
Provider Name (Legal Business Name): MATTHEW K CIRIGLIANO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 02/11/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 W MACARTHUR BLVD
OAKLAND CA
94611-5642
US

IV. Provider business mailing address

280 W MACARTHUR BLVD
OAKLAND CA
94611-5642
US

V. Phone/Fax

Practice location:
  • Phone: 510-752-6238
  • Fax: 510-752-7072
Mailing address:
  • Phone: 510-752-6238
  • Fax: 510-752-7072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number224921
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number224921
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA94154
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number054992
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: