Provider Demographics
NPI:1558468579
Name:COX, MATTHEW J (DPM)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:J
Last Name:COX
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30001 TOWN CENTER DR STEE2
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-2033
Mailing Address - Country:US
Mailing Address - Phone:949-495-2506
Mailing Address - Fax:949-495-3715
Practice Address - Street 1:30001 TOWN CENTER DR STE E2
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-2066
Practice Address - Country:US
Practice Address - Phone:949-495-2506
Practice Address - Fax:949-495-3715
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4412213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E44120OtherBLUE SHIELD
CA4696400001Medicare NSC
CA000E44120OtherBLUE SHIELD
CAE4412Medicare PIN