Provider Demographics
NPI:1952332983
Name:ZETUMER, MATTHEW ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:ROBERT
Last Name:ZETUMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5190 GOVERNOR DR. #102
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-2846
Mailing Address - Country:US
Mailing Address - Phone:858-452-9969
Mailing Address - Fax:858-452-5729
Practice Address - Street 1:5190 GOVERNOR DR. #102
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122-2846
Practice Address - Country:US
Practice Address - Phone:858-452-9969
Practice Address - Fax:858-452-5729
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA315542084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE83294Medicare UPIN
CAWA31554AMedicare ID - Type Unspecified