Michael a Mattes, DPM a Prof Corp

Primary specialty

PodiatristTaxonomy code 213E00000X

License

E3418 Issued in CA

Legal business name

MICHAEL A MATTES, DPM A PROF CORP

Practice address

13351D Riverside Dr # 604
Sherman Oaks, CA 91423-2508

Phone

(818) 789-3668

Fax

(818) 906-0777

NPI assigned

Jan 8, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Michael Alan Mattes, DPM

Title

President Owner Practitoner

Phone

(818) 789-3668

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605225600000",
    "number": "1508914235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13351D RIVERSIDE DR # 604",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914232508",
            "telephone_number": "818-789-3668",
            "fax_number": "818-906-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13351D RIVERSIDE DR # 604",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914232508",
            "telephone_number": "818-789-3668",
            "fax_number": "818-906-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL A MATTES, DPM A PROF CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A",
        "authorized_official_last_name": "MATTES",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT OWNER PRACTITONER",
        "authorized_official_telephone_number": "818-789-3668",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E3418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "E3418",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Podiatrist in Sherman Oaks, CA
• Providers in Sherman Oaks, CA by specialty
• Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2020; 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.