Provider Demographics
NPI:1053300673
Name:MATTHEWS, OSCAR A (MD)
Entity Type:Individual
Prefix:
First Name:OSCAR
Middle Name:A
Last Name:MATTHEWS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3419 VIA LIDO
Mailing Address - Street 2:# 654
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3908
Mailing Address - Country:US
Mailing Address - Phone:760-941-4005
Mailing Address - Fax:760-941-4090
Practice Address - Street 1:2095 W VISTA WAY
Practice Address - Street 2:#107
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-6027
Practice Address - Country:US
Practice Address - Phone:760-941-4005
Practice Address - Fax:760-941-4090
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-17
Last Update Date:2010-11-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA24880207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
A24176Medicare UPIN
00A248800Medicare PIN