Healthcare Provider Details

I. General information

NPI: 1245146091
Provider Name (Legal Business Name): MATTHEW SOTTO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 CLEMENT ST BUILDING 203 ROOM 1A-26
SAN FRANCISCO CA
94121
US

IV. Provider business mailing address

56 CRESTVIEW AVE
DALY CITY CA
94015-4501
US

V. Phone/Fax

Practice location:
  • Phone: 415-221-4810
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95034771
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number95034771
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: