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NPI Code Detail

MEDICARE: DR. MATTHEW MAYEDA DO, MPH

MEDICARE: DR. MATTHEW MAYEDA DO, MPH
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
1207Q00000XFamily Medicine Physician20A22274CA
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1376122804
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MATTHEW MAYEDA DO, MPH
Provider Business Mailing Address
First Line : 1179 N MCDOWELL BLVD
Second Line :
City : PETALUMA
State : CA
Zip : 94954-6559
Country : US
Telephone Number : 707-559-7500
Fax Number :
Provider Business Practice Location Address
First Line : 1179 N MCDOWELL BLVD
Second Line :
City : PETALUMA
State : CA
Zip : 94954-6559
Country : US
Telephone Number : 707-559-7500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2021
Last Update Date : 12/24/2025

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Directions to “ DR. MATTHEW MAYEDA DO, MPH” Practice Location

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