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General NPI Number Information
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NPI Number | 1720784564
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Entity Type | Individual
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Provider Name | MATTHEW DAVID STEVENSON PHARMD
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Gender | Male
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Dates
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Enumeration Date | 02/03/2023
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Last Update Date | 06/26/2024
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Provider Practice Location Address
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Address Line | 600 CITY PKWY W STE 1000
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City | ORANGE
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State | CA
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Zip | 92868-2968
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Country | US
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Telephone | 800-708-3230
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Fax |
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Provider Business Mailing Address
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Address Line | 503 LAZY CREEK CIR
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City | FULLERTON
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State | CA
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Zip | 92831-1880
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Country | US
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Telephone | 562-448-8621
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 86609
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License Number State | CA
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