Provider Demographics
NPI:1639558760
Name:MOTLEY, MATTHEW WARREN (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:WARREN
Last Name:MOTLEY
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1031 W 34TH ST STE 500
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90089-3602
Mailing Address - Country:US
Mailing Address - Phone:213-764-2800
Mailing Address - Fax:213-764-2888
Practice Address - Street 1:1031 W 34TH ST STE 500
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90089-3602
Practice Address - Country:US
Practice Address - Phone:213-764-2800
Practice Address - Fax:213-764-2888
Is Sole Proprietor?:No
Enumeration Date:2015-05-21
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2857302084P0800X
CAA1612632084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry