Provider Demographics
NPI:1477080869
Name:FIESS, MATTHEW SIMS (PA)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:SIMS
Last Name:FIESS
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:100 WILSON RD STE 100
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-7885
Mailing Address - Country:US
Mailing Address - Phone:831-242-8394
Mailing Address - Fax:
Practice Address - Street 1:850 5TH ST
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:CA
Practice Address - Zip Code:93926-9491
Practice Address - Country:US
Practice Address - Phone:831-675-3601
Practice Address - Fax:831-675-3966
Is Sole Proprietor?:No
Enumeration Date:2017-05-16
Last Update Date:2023-08-29
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant