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NPI Code Detail

MEDICARE: DAVID MATHEWS LAADC

MEDICARE: DAVID MATHEWS LAADC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1528515731
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID MATHEWS LAADC
Provider Business Mailing Address
First Line : 123 S MONTEBELLO BLVD
Second Line :
City : MONTEBELLO
State : CA
Zip : 90640-4729
Country : US
Telephone Number : 323-887-7900
Fax Number :
Provider Business Practice Location Address
First Line : 123 S MONTEBELLO BLVD
Second Line :
City : MONTEBELLO
State : CA
Zip : 90640-4729
Country : US
Telephone Number : 949-867-0987
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2016
Last Update Date : 10/03/2024

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Directions to “ DAVID MATHEWS LAADC” Practice Location

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