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General NPI Number Information
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NPI Number | 1578875746
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Entity Type | Individual
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Provider Name | MATTHEW TODD MORRIS M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/05/2010
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Last Update Date | 01/18/2024
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Provider Practice Location Address
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Address Line | 844 OLD TUNNEL RD
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City | GRASS VALLEY
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State | CA
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Zip | 95945-8524
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Country | US
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Telephone | 530-274-9762
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Fax | 530-273-7255
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Provider Business Mailing Address
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Address Line | 844 OLD TUNNEL RD
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City | GRASS VALLEY
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State | CA
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Zip | 95945-8524
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Country | US
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Telephone | 302-749-7625
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Fax | 530-273-7255
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | R8978
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD-42014
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License Number State | IA
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