Provider Demographics
NPI:1922441187
Name:MATTHEW, BINOJ JOSEPH (MD, MHA)
Entity Type:Individual
Prefix:DR
First Name:BINOJ
Middle Name:JOSEPH
Last Name:MATTHEW
Suffix:
Gender:M
Credentials:MD, MHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 E CHAMPLAIN DR APT 131
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93730-1294
Mailing Address - Country:US
Mailing Address - Phone:559-355-0590
Mailing Address - Fax:
Practice Address - Street 1:4700 NORTHGATE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-1149
Practice Address - Country:US
Practice Address - Phone:916-929-6161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-08
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA138022261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine