Provider Demographics
NPI:1306163795
Name:MATTHEWS, MICHAEL STEPHEN (OD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:STEPHEN
Last Name:MATTHEWS
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:3145 ROSECRANS ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-4800
Mailing Address - Country:US
Mailing Address - Phone:619-224-2973
Mailing Address - Fax:619-224-0106
Practice Address - Street 1:3145 ROSECRANS ST
Practice Address - Street 2:SUITE C
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-4800
Practice Address - Country:US
Practice Address - Phone:619-224-2973
Practice Address - Fax:619-224-0106
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-26
Last Update Date:2023-03-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA06083T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist