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NPI Code Detail

MEDICARE: MATTHEW JEW DPT

MEDICARE: MATTHEW JEW DPT
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 TherapistCA

General Provider Information

NPI Number : 1780312413
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW JEW DPT
Provider Business Mailing Address
First Line : 320 POMPANO CIR
Second Line :
City : FOSTER CITY
State : CA
Zip : 94404-1904
Country : US
Telephone Number : 650-393-0452
Fax Number :
Provider Business Practice Location Address
First Line : 1779 WOODSIDE RD STE 102
Second Line :
City : REDWOOD CITY
State : CA
Zip : 94061-3461
Country : US
Telephone Number : 650-780-9700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2022
Last Update Date : 08/10/2022

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