Individual
MATTHEW GREGORY WEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
50 COMMERCIAL WAY, FALLON, NV 89406-2600
(775) 455-4254
(775) 242-4591
Mailing address
50 COMMERCIAL WAY, FALLON, NV 89406-2600
(775) 455-4254
(775) 242-4591
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA0419
NV
363A00000X
Physician Assistant
PA1381
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12436250
CAQH
—
05
—
1811248933
—
NV
Enumeration date
09/28/2012
Last updated
10/03/2024
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