Provider Demographics
NPI:1184783508
Name:HECHT, MATTHEW L (M D)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:L
Last Name:HECHT
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4161 REDONDO BEACH BLVD
Mailing Address - Street 2:STE 300
Mailing Address - City:LAWNDALE
Mailing Address - State:CA
Mailing Address - Zip Code:90260-3306
Mailing Address - Country:US
Mailing Address - Phone:310-370-5648
Mailing Address - Fax:
Practice Address - Street 1:4161 REDONDO BEACH BLVD
Practice Address - Street 2:STE 300
Practice Address - City:LAWNDALE
Practice Address - State:CA
Practice Address - Zip Code:90260-3306
Practice Address - Country:US
Practice Address - Phone:310-370-5648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA064034207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A640340Medicaid
CAG69982Medicare UPIN
CA00A640340Medicaid