Individual
DR. MATTHEW JOSEPH ENNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9033 WILSHIRE BLVD, SUITE 403, BEVERLY HILLS, CA 90211-1837
(310) 858-3880
(888) 589-6241
Mailing address
9033 WILSHIRE BLVD, SUITE 403, BEVERLY HILLS, CA 90211-1837
(310) 858-3880
(888) 589-6241
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
A100628
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45-2457553
CORPORATE TAX ID#
CA
Enumeration date
05/16/2006
Last updated
09/12/2012
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