Individual
MATTHEW CHARLES KIDD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2238 PASEO DEL REY ST, NEEDLES, CA 92363-3520
(760) 326-2340
(760) 326-2340
Mailing address
2238 PASEO DEL REY ST, NEEDLES, CA 92363-3520
(760) 326-2340
(760) 326-2340
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
G37237
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G372370
—
CA
05
—
185307-02
—
AZ
01
—
C379870
BLUE CROSS OF CA
CA
01
—
G372370
BLUE SHIELD OF CA
CA
01
—
TRAVELERS
00G372370
—
Enumeration date
08/20/2005
Last updated
10/29/2007
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