Healthcare Provider Details

I. General information

NPI: 1790933521
Provider Name (Legal Business Name): MATTHEW DAVID EPSTEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2008
Last Update Date: 12/08/2023
Certification Date: 12/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 PARNASSUS AVE # M396 CAMPUS BOX 0628
SAN FRANCISCO CA
94143-0628
US

IV. Provider business mailing address

2125 OAK GROVE RD 200
WALNUT CREEK CA
94598-2520
US

V. Phone/Fax

Practice location:
  • Phone: 503-317-6336
  • Fax:
Mailing address:
  • Phone: 925-296-7150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberA119143
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: