MEDICARE: MATTHEW TOPPER

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	171W00000X	Contractor

General Provider Information

NPI Number	:	1942627765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW TOPPER

Provider Business Mailing Address
First Line	:	2254 SAN DIEGO AVE
Second Line	:	SUITE 200
City	:	SAN DIEGO
State	:	CA
Zip	:	92110-2944
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2254 SAN DIEGO AVE
Second Line	:	SUITE 200
City	:	SAN DIEGO
State	:	CA
Zip	:	92110-2944
Country	:	US
Telephone Number	:	619-260-6110
Fax Number	:

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

Provider Enumeration Date	:	03/19/2014
Last Update Date	:	03/19/2014

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Directions to “ MATTHEW TOPPER ” Practice Location

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