Provider Demographics
NPI:1285351122
Name:ARIAS, MATTHEW (ATC)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:ARIAS
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2564
Mailing Address - Street 2:
Mailing Address - City:CARMEL BY THE SEA
Mailing Address - State:CA
Mailing Address - Zip Code:93921-2564
Mailing Address - Country:US
Mailing Address - Phone:657-418-7140
Mailing Address - Fax:
Practice Address - Street 1:MISSION ST. 3 NW OF 6TH AVE, MISSION ST
Practice Address - Street 2:
Practice Address - City:CARMEL-BY-THE-SEA
Practice Address - State:CA
Practice Address - Zip Code:93921
Practice Address - Country:US
Practice Address - Phone:657-418-7140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-21
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20000170392255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer