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NPI Code Detail

MEDICARE: MATTHEW GREG LEFFERMAN DO

MEDICARE: MATTHEW GREG LEFFERMAN DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician20A8857CA

General Provider Information

NPI Number : 1184622417
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW GREG LEFFERMAN DO
Provider Business Mailing Address
First Line : 9233 W. PICO BLVD.
Second Line : SUITE #230
City : LOS ANGELES
State : CA
Zip : 90035-1385
Country : US
Telephone Number : 310-356-8146
Fax Number : 310-356-8142
Provider Business Practice Location Address
First Line : 9233 W. PICO BLVD.
Second Line : SUITE #230
City : LOS ANGELES
State : CA
Zip : 90035-1385
Country : US
Telephone Number : 310-356-8146
Fax Number : 310-356-8142
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2005
Last Update Date : 01/13/2011

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