Individual
MATTHEW ROUGHLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
280 S MAIN ST STE 200, ORANGE, CA 92868-3852
(714) 937-2155
(714) 634-4321
Mailing address
280 S MAIN ST STE 200, ORANGE, CA 92868-3852
(714) 937-2155
(714) 634-4321
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/05/2020
Last updated
09/27/2023
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