Individual
DR. RAY VERN MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1520 SAN PABLO ST, SUITE 1000, LOS ANGELES, CA 90033-5310
(323) 442-5100
Mailing address
PO BOX 31309, LOS ANGELES, CA 90031-0309
(323) 442-5100
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
G54794
CA
207RC0000X
Cardiovascular Disease Physician
G54794
CA
207RI0011X
Interventional Cardiology Physician
Primary
G54794
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G547940
—
CA
01
—
060049073
MEDICARE RAILROAD
CA
01
—
1902846306
GROUP NPI
CA
01
—
GR0100430
GROUP MEDICAL
CA
01
—
W18762
GROUP MEDICARE
CA
Enumeration date
09/07/2005
Last updated
11/27/2023
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