Active NPI
Mark A. Matthews
- Licensed Practical Nurse
- Los Angeles, CA
National Provider Identifier
1013101914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- LVN 180296
- Practice address
- 6310 7TH Ave
6313 7TH Avenue
Los Angeles, CA 90043-4275 - Phone
- (323) 778-0718
- NPI assigned
- Sep 4, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | LVN 180296 | CA | Primary |
Addresses
Primary practice location
6310 7TH Ave
6313 7TH Avenue
Los Angeles, CA 90043-4275
Mailing address
6310 7TH Ave
6313 7TH Avenue
Los Angeles, CA 90043-4275
Phone (323) 778-0718
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LVN 180296 | CA | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188864000000",
"number": "1013101914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6310 7TH AVE",
"address_2": "6313 7TH AVENUE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900434275",
"telephone_number": "323-778-0718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6310 7TH AVE",
"address_2": "6313 7TH AVENUE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900434275",
"telephone_number": "323-778-0718"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTHEWS",
"first_name": "MARK",
"middle_name": "A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-09-04",
"last_updated": "2007-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "CA",
"license": "LVN 180296",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.