1841297272 NPI number — DR. MATTHEW E. PASTO M.D.

Table of content: DR. MATTHEW E. PASTO M.D. (NPI 1841297272)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841297272 NPI number — DR. MATTHEW E. PASTO M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PASTO
Provider First Name:
MATTHEW
Provider Middle Name:
E.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841297272
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/04/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
RADIOLOGICAL ASSOCIATES MEDICAL GROUP
Provider Second Line Business Mailing Address:
2410 SAMARITAN DR., SUITE 101
Provider Business Mailing Address City Name:
SAN JOSE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95124
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-371-0390
Provider Business Mailing Address Fax Number:
408-371-0462

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
GOOD SAMARITAN HOSPITAL - RADIOLOGY
Provider Second Line Business Practice Location Address:
2425 SAMARITAN DR.
Provider Business Practice Location Address City Name:
SAN JOSE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95124
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-559-2146
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/30/2005

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: 2085R0202X , with the licence number:  A031256 , 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)

  • Identifier: GROO12480 . This is a "MEDICAL" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 000793222 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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