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Individual
DR. MATTHEW S HENDRICKSON
Active
Individual
DR. MATTHEW S HENDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G77309
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G773090
BC OF CA
—
05
—
00G773090
—
CA
01
—
G77309
BS OF CA
—
Enumeration date
06/09/2006
Last updated
10/28/2013
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