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General NPI Number Information
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NPI Number | 1811248933
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Entity Type | Individual
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Provider Name | MATTHEW GREGORY WEST PA
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Gender | Male
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Dates
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Enumeration Date | 09/28/2012
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 50 COMMERCIAL WAY
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City | FALLON
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State | NV
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Zip | 89406-2600
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Country | US
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Telephone | 775-455-4254
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Fax | 775-242-4591
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Provider Business Mailing Address
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Address Line | 50 COMMERCIAL WAY
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City | FALLON
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State | NV
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Zip | 89406-2600
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Country | US
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Telephone | 775-455-4254
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Fax | 775-242-4591
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA1381
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA0419
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License Number State | NV
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