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General NPI Number Information
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NPI Number | 1518744655
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Entity Type | Organization
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Legal Business Name | DR MATTHEW PALEY A PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 09/12/2023
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Last Update Date | 09/12/2023
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Provider Practice Location Address
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Address Line | 655 REDWOOD HIGHWAY STE 332
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City | MILL VALLEY
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State | CA
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Zip | 94941
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Country | US
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Telephone | 510-214-6655
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Fax | 279-300-3958
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Provider Business Mailing Address
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Address Line | PO BOX 1770
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City | LA MESA
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State | CA
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Zip | 91944-1770
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Country | US
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Telephone | 619-464-1165
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Fax | 619-567-1011
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Authorized Official
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Title or Position | OWNER
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Name | MATTHEW PALEY
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Credential | DO
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Telephone | 510-214-6655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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