Individual
MICHAEL MCLANE MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CCMA
Contact information
Practice address
1950 E 17TH ST, SANTA ANA, CA 92705-6852
(714) 547-5375
Mailing address
1333 S MAYFLOWER AVE STE 220, MONROVIA, CA 91016-5239
(512) 661-8103
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
363AM0700X
Medical Physician Assistant
Primary
T7A7N8C3
—
Other
Enumeration date
01/11/2023
Last updated
02/18/2023
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