Matthew J Nykiel MD, Inc

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

A120256 Issued in CA

Legal business name

MATTHEW J NYKIEL MD, INC

Practice address

1113 Alta Ave Ste 103
Upland, CA 91786-2803

Phone

(949) 429-0890

Fax

(949) 340-0696

NPI assigned

Sep 17, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Matthew J Nykiel, MD

Title

President

Phone

(909) 291-4900

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613606400000",
    "number": "1548662992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1113 ALTA AVE STE 103",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917862803",
            "telephone_number": "949-429-0890",
            "fax_number": "949-340-0696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 ALTA AVE STE 103",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917862803",
            "telephone_number": "949-429-0890",
            "fax_number": "949-340-0696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW J NYKIEL MD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-17",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A",
        "authorized_official_last_name": "NYKIEL",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-291-4900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "A120256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raymond Martinez III
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• Plastic and Reconstructive Surgery Physician in Upland, CA
• Providers in Upland, CA by specialty
• Plastic and Reconstructive Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; 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.