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NPI Code Detail

MEDICARE: MATTHEW SLOCUM

MEDICARE:   MATTHEW  SLOCUM
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
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1326506973
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW SLOCUM
Provider Business Mailing Address
First Line : 1410 STEPHEN WAY
Second Line :
City : SAN JOSE
State : CA
Zip : 95129-4143
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1912 S PACIFIC COAST HWY
Second Line :
City : REDONDO BEACH
State : CA
Zip : 90277-6118
Country : US
Telephone Number : 103-540-5758
Fax Number : 310-540-5404
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2019
Last Update Date : 05/21/2024

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Directions to “ MATTHEW SLOCUM ” Practice Location

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