Blundell, Matthew Charles
Blundell, Matthew Charles is an individual health care provider with primary practice located at 1771 Northcrest Dr , Crescent City CA 95531-8922. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Blundell, Matthew Charles can be contacted via phone (707) 465-8666.Contact Information
Primary practice address
1771 Northcrest Dr
Crescent City CA 95531-8922
Phone: (707) 465-8666
Fax: (707) 465-8650
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | A62659 | California |
Profile Details
| NPI number | 1073511796 |
|---|---|
| LBN Legal business name | Blundell, Matthew Charles |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 7th, 2005 |
| Last updated | Sep 13th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073511796 | NPPES |
| California | MEDICAID | 00A626590 | |
| California | Other | 103292 |
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