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General NPI Number Information
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NPI Number | 1710182779
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Entity Type | Individual
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Provider Name | MATTHEW T SIEDHOFF MD
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Gender | Male
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Dates
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Enumeration Date | 06/19/2007
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 450 N ROXBURY DR SUITE 101
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City | BEVERLY HILLS
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State | CA
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Zip | 90210
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Country | US
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Telephone | 310-997-4884
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Fax | 310-579-4992
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Provider Business Mailing Address
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Address Line | 9903 SANTA MONICA BLVD #208
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City | BEVERLY HILLS
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State | CA
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Zip | 90212
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Country | US
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Telephone | 310-997-4884
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Fax | 310-579-4992
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 2009-00884
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 138819
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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