Active NPI
Matthew Callan
- Specialist
- Upland, CA
National Provider Identifier
1376999177
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 550
- Practice address
- 818 N Mountain Ave Ste 207
Upland, CA 91786-4165 - Phone
- (909) 860-8446
- NPI assigned
- May 11, 2016
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 550 | CA | Primary |
Addresses
Primary practice location
818 N Mountain Ave Ste 207
Upland, CA 91786-4165
Mailing address
154 W Foothill Blvd Ste a
#345
Upland, CA 91786-8702
Phone (909) 860-8446
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 |
|---|---|---|---|
| 550 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462924800000",
"number": "1376999177",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "154 W FOOTHILL BLVD STE A",
"address_2": "#345",
"city": "UPLAND",
"state": "CA",
"postal_code": "917868702",
"telephone_number": "909-860-8446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "818 N MOUNTAIN AVE STE 207",
"city": "UPLAND",
"state": "CA",
"postal_code": "917864165",
"telephone_number": "909-860-8446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALLAN",
"first_name": "MATTHEW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-05-11",
"last_updated": "2016-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "550",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Upland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.