Mateo Medical Group

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

MATEO MEDICAL GROUP

Practice address

2905 S El Camino Real
San Mateo, CA 94403-2730

Phone

(650) 570-2273

Fax

(650) 570-4266

NPI assigned

Sep 6, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Denise Kubick

Title

Manager

Phone

(650) 685-9940

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189036800000",
    "number": "1083809768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 S EL CAMINO REAL",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944032730",
            "telephone_number": "650-570-2273",
            "fax_number": "650-570-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 S EL CAMINO REAL",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944032730",
            "telephone_number": "650-570-2273",
            "fax_number": "650-570-4266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATEO MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-06",
        "last_updated": "2007-09-06",
        "status": "A",
        "authorized_official_last_name": "KUBICK",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "650-685-9940",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joy Mason, P.T.A., A.T.C.
• Vincent Renaldo Mason, MD
• Quiara Mataele
• Diamond Matautia
• Mateo Lodge, Inc.
• Catherine A Mathews
• Zara Rachel Mathews, M.D.
• Jaqueline Mathiesen, SUD COUNSELOR
• Ajay Mathur, DDS
• Anna Matkowski

• Specialist in San Mateo, CA
• Providers in San Mateo, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.

Verify at the official NPI Registry.