Provider Demographics
NPI:1821871369
Name:ARREOLA, MATTHEW ISAAC
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:ISAAC
Last Name:ARREOLA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17058 E BYGROVE ST
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91722-1209
Mailing Address - Country:US
Mailing Address - Phone:626-324-1911
Mailing Address - Fax:
Practice Address - Street 1:17058 E BYGROVE ST
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91722-1209
Practice Address - Country:US
Practice Address - Phone:626-324-1911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer