1699096248 NPI number — MS. MARGARET YEN-CHUANG MATTHEWS P.T.

Table of content: SARA LYN HURT LMP (NPI 1518287929)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699096248 NPI number — MS. MARGARET YEN-CHUANG MATTHEWS P.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MATTHEWS
Provider First Name:
MARGARET
Provider Middle Name:
YEN-CHUANG
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
P.T.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHUANG
Provider Other First Name:
MARGARET
Provider Other Middle Name:
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1699096248
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/10/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
102 CATHERINE LN STE A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRASS VALLEY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95945-5701
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
530-478-1933
Provider Business Mailing Address Fax Number:
530-478-1937

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
102 CATHERINE LN STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GRASS VALLEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95945-5701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-478-1933
Provider Business Practice Location Address Fax Number:
530-478-1933
Provider Enumeration Date:
06/17/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  PT 35594 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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