Provider Demographics
NPI:1356405583
Name:MATOSO-TOGNETTI, INC.
Entity type:Organization
Organization Name:MATOSO-TOGNETTI, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:HIGHTOWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-345-2739
Mailing Address - Street 1:1810 GATEWAY DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94404-2470
Mailing Address - Country:US
Mailing Address - Phone:650-345-2739
Mailing Address - Fax:650-345-2756
Practice Address - Street 1:1810 GATEWAY DR
Practice Address - Street 2:SUITE 110
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94404-2470
Practice Address - Country:US
Practice Address - Phone:650-345-2739
Practice Address - Fax:650-345-2756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT295852251S0007X
CAPT283472251S0007X
CAPT1423X2251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ01917ZMedicare ID - Type Unspecified