Provider Demographics
NPI:1922184969
Name:ZEREBNY, MATTHEW D (DC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:D
Last Name:ZEREBNY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15520 ROCKFIELD BLVD A200
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-6705
Mailing Address - Country:US
Mailing Address - Phone:949-598-9999
Mailing Address - Fax:949-598-9990
Practice Address - Street 1:901S STATE ST 500
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-7185
Practice Address - Country:US
Practice Address - Phone:951-652-2752
Practice Address - Fax:951-652-3582
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC21577111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0215770Medicare ID - Type Unspecified
CAU53260Medicare UPIN