Provider Demographics
NPI:1205033073
Name:OSTROM, MATTHEW PHILLIP (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:PHILLIP
Last Name:OSTROM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2841 LOMITA BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-5116
Mailing Address - Country:US
Mailing Address - Phone:310-257-0508
Mailing Address - Fax:310-325-8109
Practice Address - Street 1:2841 LOMITA BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5116
Practice Address - Country:US
Practice Address - Phone:310-257-0508
Practice Address - Fax:310-325-8109
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2017-03-08
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Provider Licenses
StateLicense IDTaxonomies
CAA94925207RC0000X, 207RC0001X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine