Individual provider · NPI-1

Matthew Thomas Brady

Surgery · Mission Viejo, CA

NPI number1376863621
StatusActive
Last updated in NPPESFeb 26, 2021

Details

NPI
1376863621
Entity type
Individual (NPI-1)
Name
Mr. Matthew Thomas Brady
Sex
Male
Sole proprietor
No
Enumeration date
Jun 9, 2010
Certification date
Feb 26, 2021
Last updated
Feb 26, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208600000X Surgery243999CAYes
208600000X Surgery243999MA

Practice location

26732 Crown Valley Pkwy Ste 351
Mission Viejo, CA 92691-6374

Phone 949-364-1007 · Fax 949-364-0317

Mailing address

26732 Crown Valley Pkwy Ste 351
Mission Viejo, CA 92691-6374

Phone 949-364-1007 · Fax 949-364-0317

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