Healthcare Provider Details

I. General information

NPI: 1851520878
Provider Name (Legal Business Name): JAMES CRAIG MATHEWS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2009
Last Update Date: 01/13/2022
Certification Date: 01/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 SAINT JOSEPHS AVE
SAN FRANCISCO CA
94115-3255
US

IV. Provider business mailing address

4501 SAND CREEK RD
ANTIOCH CA
94531-8687
US

V. Phone/Fax

Practice location:
  • Phone: 415-833-3870
  • Fax:
Mailing address:
  • Phone: 925-813-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberA127119
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: