Provider Demographics
NPI:1306123229
Name:SCHULTZEL, MATTHEW MARK (DO)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:MARK
Last Name:SCHULTZEL
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:9850 GENESEE AVE STE 570
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1229
Mailing Address - Country:US
Mailing Address - Phone:858-207-3117
Mailing Address - Fax:951-698-0272
Practice Address - Street 1:9850 GENESEE AVE STE 570
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037
Practice Address - Country:US
Practice Address - Phone:858-207-3117
Practice Address - Fax:951-698-0272
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-05
Last Update Date:2018-06-21
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Provider Licenses
StateLicense IDTaxonomies
CA11955208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery