Individual
DR. LYDIA MATKOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G80774
CA
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
G80774
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G807740
BLUE SHIELD
CA
05
—
00G807740
—
CA
05
—
00G807741
—
CA
01
—
P00286193
RAILROAD MEDICARE
CA
Enumeration date
06/18/2006
Last updated
11/21/2019
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