Healthcare Provider Details

I. General information

NPI: 1700147311
Provider Name (Legal Business Name): MATTHEW TIMOTHY MUFFLY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2012
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W CARSON ST # 422
TORRANCE CA
90502-2059
US

IV. Provider business mailing address

2811 WILSHIRE BLVD STE 800
SANTA MONICA CA
90403-4808
US

V. Phone/Fax

Practice location:
  • Phone: 424-306-7874
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA149577
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: