Individual
MARK A. MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6310 7TH AVE, 6313 7TH AVENUE, LOS ANGELES, CA 90043-4275
(323) 778-0718
Mailing address
6310 7TH AVE, 6313 7TH AVENUE, LOS ANGELES, CA 90043-4275
(323) 778-0718
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LVN 180296
CA
Other
Enumeration date
09/04/2007
Last updated
09/04/2007
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