Provider Demographics
NPI:1811027360
Name:ANDREW J MATTHEWS, MD
Entity Type:Organization
Organization Name:ANDREW J MATTHEWS, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:J
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-848-0222
Mailing Address - Street 1:7880 WREN AVE
Mailing Address - Street 2:SUITE# F-161
Mailing Address - City:GILROY
Mailing Address - State:CA
Mailing Address - Zip Code:95020-4943
Mailing Address - Country:US
Mailing Address - Phone:408-848-0222
Mailing Address - Fax:408-848-0220
Practice Address - Street 1:7880 WREN AVE
Practice Address - Street 2:SUITE# F-161
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020-4943
Practice Address - Country:US
Practice Address - Phone:408-848-0222
Practice Address - Fax:408-848-0220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG86007208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ21529ZMedicare PIN