Lydia Matkovich, M.D. a Medical Corporation

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

G80774 Issued in CA

Legal business name

LYDIA MATKOVICH, M.D. A MEDICAL CORPORATION

Practice address

23600 Telo Ave
Suite 210
Torrance, CA 90505-4035

Phone

(310) 626-8055

Fax

(310) 626-8058

NPI assigned

Jun 18, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Lydia Matkovich, M.D.NPI 1508801028

Title

Owner

Phone

(310) 626-8055

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Lydia Matkovich, M.D.

  • Ophthalmology Physician
  • Torrance, CA
  • NPI 1508801028
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204675200000",
    "number": "1699710145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23600 TELO AVE",
            "address_2": "SUITE 210",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054035",
            "telephone_number": "310-626-8055",
            "fax_number": "310-626-8058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23600 TELO AVE",
            "address_2": "SUITE 210",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054035",
            "telephone_number": "310-626-8055",
            "fax_number": "310-626-8058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYDIA MATKOVICH, M.D. A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2008-03-05",
        "status": "A",
        "authorized_official_last_name": "MATKOVICH",
        "authorized_official_first_name": "LYDIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-626-8055",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G80774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G807740",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00286193",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G807741",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "006807740",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jocelyn Haidee Luz
• Alexandra Ly
• Melissa Ly, OTR/L
• Thao Ly
• Lydia M. Pak, D.D.S., Inc.
• Laura Lyman, PSY.D.
• Lymphavilla Occupational Therapy Inc.
• Akiela Lynch
• Christopher Tai Lynch, M.D.
• Cristal Melanie Lynch, M.D.

• Ophthalmology Physician in Torrance, CA
• Providers in Torrance, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.