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Individual

MATTHEW D WHEALON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
400 N. PEPPER AVE., MOB SUITE 308, COLTON, CA 92324-1801
(909) 580-3353
(909) 580-1363
Mailing address
PO BOX 670, REDLANDS, CA 92373-0221
(909) 580-3353
(909) 580-1363

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
A128935
CA
208C00000X
Colon & Rectal Surgery Physician
Primary
A128935
CA
208C00000X
Colon & Rectal Surgery Physician
MD464833
PA
208C00000X
Colon & Rectal Surgery Physician
MT216910
PA

Other

Enumeration date
04/18/2012
Last updated
03/10/2020
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