Provider Demographics
NPI:1215390935
Name:NEOH, MATTHEW
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:NEOH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 THE CROSSROADS BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93923-8685
Mailing Address - Country:US
Mailing Address - Phone:831-718-9701
Mailing Address - Fax:831-886-3649
Practice Address - Street 1:275 THE CROSSROADS BLVD STE A
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:CA
Practice Address - Zip Code:93923-8685
Practice Address - Country:US
Practice Address - Phone:831-718-9701
Practice Address - Fax:831-886-3649
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-30
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA162365207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine