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General NPI Number Information
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NPI Number | 1780044735
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Entity Type | Organization
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Legal Business Name | MATTHEW S MCCARTY MD INC
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Dates
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Enumeration Date | 03/03/2016
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Last Update Date | 10/17/2017
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Provider Practice Location Address
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Address Line | 1800 SPRING RIDGE DR
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City | SUSANVILLE
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State | CA
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Zip | 96130-6100
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Country | US
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Telephone | 702-453-3799
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Fax | 702-453-5741
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Provider Business Mailing Address
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Address Line | PO BOX 349
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City | LOMA LINDA
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State | CA
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Zip | 92354-0349
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Country | US
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Telephone | 702-453-3799
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Fax | 702-453-5741
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Authorized Official
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Title or Position | PRESIDENT
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Name | MATTHEW STEPHEN MCCARTY
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Credential | MD
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Telephone | 602-686-1129
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NR1301X
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Taxonomy Name | Rural Acute Care Hospital
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License Number | 51959
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 61470
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A126240
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License Number State | CA
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