Provider Demographics
NPI:1639476401
Name:COLTON, MATTHEW AARON (PA-C)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:AARON
Last Name:COLTON
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3525 SCAMP ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92124-3312
Mailing Address - Country:US
Mailing Address - Phone:727-251-3605
Mailing Address - Fax:
Practice Address - Street 1:1628 PALM AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92154-1027
Practice Address - Country:US
Practice Address - Phone:619-591-9999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-14
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical