MEDICARE: MATTHEW AARON COLTON PA-C

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	363AM0700X	Medical Physician Assistant

General Provider Information

NPI Number	:	1639476401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW AARON COLTON PA-C

Provider Business Mailing Address
First Line	:	3525 SCAMP ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92124-3312
Country	:	US
Telephone Number	:	727-251-3605
Fax Number	:

Provider Business Practice Location Address
First Line	:	1628 PALM AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92154-1027
Country	:	US
Telephone Number	:	619-591-9999
Fax Number	:

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

Provider Enumeration Date	:	02/14/2011
Last Update Date	:	08/02/2019

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