Provider Demographics
NPI:1316389166
Name:SEITZ, MATTHEW W
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:W
Last Name:SEITZ
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 1:9404 GENESEE AVE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1339
Mailing Address - Country:US
Mailing Address - Phone:858-455-1222
Mailing Address - Fax:858-455-7101
Practice Address - Street 1:9404 GENESEE AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1339
Practice Address - Country:US
Practice Address - Phone:858-455-1222
Practice Address - Fax:858-455-7101
Is Sole Proprietor?:No
Enumeration Date:2013-07-22
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist