Individual
MATTHEW DAVID TADLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9000
(800) 926-8273
(619) 532-6299
Mailing address
PO BOX 232410, SAN DIEGO, CA 92193-2410
Taxonomy
Speciality
Code
Description
License number
State
2083A0100X
Aerospace Medicine Physician
01058634A
IN
2086S0102X
Surgical Critical Care Physician
Primary
C54740
CA
Other
Enumeration date
02/03/2006
Last updated
09/22/2020
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