Provider Demographics
NPI:1235298803
Name:MATICH, ANNE EMILY (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:EMILY
Last Name:MATICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANNE
Other - Middle Name:EMILY
Other - Last Name:CASEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4405 VANDEVER AVENUE
Mailing Address - Street 2:DEPARTMENT OF NEUROLOGY
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120
Mailing Address - Country:US
Mailing Address - Phone:619-528-5000
Mailing Address - Fax:619-516-6598
Practice Address - Street 1:4405 VANDEVER AVE
Practice Address - Street 2:DEPARTMENT OF NEUROLOGY
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-3315
Practice Address - Country:US
Practice Address - Phone:619-528-5000
Practice Address - Fax:619-516-6598
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA654062084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology