Provider Demographics
NPI:1700825916
Name:MATTHEWS, CHRISTOPHER PODGORSKI (DO)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:PODGORSKI
Last Name:MATTHEWS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:CHRIS
Other - Middle Name:
Other - Last Name:MATTHEWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:517 N CEDROS AVE
Mailing Address - Street 2:
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-4205
Mailing Address - Country:US
Mailing Address - Phone:562-208-5697
Mailing Address - Fax:858-350-8109
Practice Address - Street 1:11200 SW MURRAY SCHOLLS PL
Practice Address - Street 2:SUITE 100
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97007-9816
Practice Address - Country:US
Practice Address - Phone:503-813-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8029207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH94029Medicare UPIN