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NPI Code Detail

MEDICARE: MATTHEW JAMES EASTON D.O.

MEDICARE: MATTHEW JAMES EASTON D.O.
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 Physician20A7946CA

General Provider Information

NPI Number : 1841397718
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW JAMES EASTON D.O.
Provider Business Mailing Address
First Line : 2740 HERNDON AVE
Second Line : P.O. BOX 427
City : CLOVIS
State : CA
Zip : 93611-6813
Country : US
Telephone Number : 559-299-4264
Fax Number : 559-299-1421
Provider Business Practice Location Address
First Line : 445 11TH ST
Second Line :
City : ORANGE COVE
State : CA
Zip : 93646-2211
Country : US
Telephone Number : 559-626-4031
Fax Number : 559-626-4963
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 08/01/2016

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Directions to “ MATTHEW JAMES EASTON D.O.” Practice Location

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