Provider Demographics
NPI:1841262946
Name:SCIARONI, MATTHEW H (DPM)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:H
Last Name:SCIARONI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1821 E OAK HAVEN
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93728
Mailing Address - Country:US
Mailing Address - Phone:559-434-1830
Mailing Address - Fax:559-433-6947
Practice Address - Street 1:1191 E HERNDON AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3164
Practice Address - Country:US
Practice Address - Phone:559-431-3838
Practice Address - Fax:559-435-1105
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE3408213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE3408OtherST OF CA
CA00E34080Medicaid
CA00E34080Medicaid
CAE3408OtherST OF CA