MEDICARE: DR. MATTHEW PALEY 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
1	390200000X	Student in an Organized Health Care Education/Training Program	BP10067069	TX
2	2084P0800X	Psychiatry Physician	20A19906	CA

General Provider Information

NPI Number	:	1396303756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW PALEY DO

Provider Business Mailing Address
First Line	:	PO BOX 1770
Second Line	:
City	:	LA MESA
State	:	CA
Zip	:	91944-1770
Country	:	US
Telephone Number	:	619-464-1165
Fax Number	:	619-567-1011

Provider Business Practice Location Address
First Line	:	655 REDWOOD HWY
Second Line	:	STE 332
City	:	MILL VALLEY
State	:	CA
Zip	:	94941-3057
Country	:	US
Telephone Number	:	510-214-6655
Fax Number	:	279-300-3958

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2019
Last Update Date	:	09/12/2023

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