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Individual

MATTHEW EVAN MODES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
8700 BEVERLY BLVD, WEST HOLLYWOOD, CA 90048-1804
(310) 423-8784
(310) 423-2665
Mailing address
4140 W 190TH ST, TORRANCE, CA 90504-5513
(310) 967-1780
(866) 991-4287

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD60649656
WA
207RP1001X
Pulmonary Disease Physician
Primary
A170987
CA
207RP1001X
Pulmonary Disease Physician
MD60649656
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1992144729
WA
Enumeration date
06/14/2013
Last updated
01/13/2021
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