Provider Demographics
NPI:1457749574
Name:MATTHEW DAWE, M.D., INC.
Entity type:Organization
Organization Name:MATTHEW DAWE, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:DAWE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-348-5181
Mailing Address - Street 1:5743 CORSA AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-4027
Mailing Address - Country:US
Mailing Address - Phone:818-348-5181
Mailing Address - Fax:818-348-5339
Practice Address - Street 1:5743 CORSA AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-4027
Practice Address - Country:US
Practice Address - Phone:818-348-5181
Practice Address - Fax:818-348-5339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-23
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFO2334Medicare UPIN