Individual
DR. MATTHEW BAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
BLDG #50, FARENHOLT AVE, AGANA HEIGHTS, GU 96910
(671) 344-9202
Mailing address
4635 TIVOLI ST, SAN DIEGO, CA 92107-3833
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
207R00000X
Internal Medicine Physician
Primary
A157303
CA
208M00000X
Hospitalist Physician
M-2273
GU
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
VAD0000
—
CA
Enumeration date
06/26/2017
Last updated
02/22/2023
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