Organization Active NPI

Matthew M. DO. DPM a Proffesional Corporation

  • Podiatrist
  • Costa Mesa, CA
National Provider Identifier
1255478129
Registry record updated Nov 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E3881 Issued in CA
Legal business name
MATTHEW M. DO. DPM A PROFFESIONAL CORPORATION
Practice address
275 Victoria St
Ste 1D
Costa Mesa, CA 92627-1906
Phone
(949) 645-3338
NPI assigned
Jan 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2007

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

Authorized official

Name
Matthew M DO, DPM
Title
Doctor of Podiatric Medicine
Phone
(949) 645-3338

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213E00000X E3881 CA Primary
Primary Podiatric Medicine PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213EP1101X E3881 CA
Foot & Ankle Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0103X E3881 CA

Addresses

Primary practice location

275 Victoria St
Ste 1D
Costa Mesa, CA 92627-1906

Mailing address

275 Victoria St
Ste 1D
Costa Mesa, CA 92627-1906

National Provider Directory

National Provider Directory

Locations

275 Victoria St
Ste 1D
Costa Mesa, CA 92627
Phone (949) 645-3338

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195084800000",
    "number": "1255478129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 VICTORIA ST",
            "address_2": "STE 1D",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926271906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 VICTORIA ST",
            "address_2": "STE 1D",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926271906",
            "telephone_number": "949-645-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW M. DO. DPM A PROFFESIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-11-15",
        "status": "A",
        "authorized_official_last_name": "DO",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DOCTOR OF PODIATRIC MEDICINE",
        "authorized_official_telephone_number": "949-645-3338",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E3881",
            "primary": true
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "CA",
            "license": "E3881",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E3881",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.