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MATTHEW ROLAND NOTHERN NP PAC

>> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1124117700

Individual Registrant:
 MATTHEW ROLAND NOTHERN NP PAC
Gender: M
Not Sole Proprietor

Location and contact information for practice:
3200 LONG BEACH BOULEVARD  LONG BECH, CA 90806-5062 US
Tel: 562-981-6865  Fax: 562-595-6471

Contact information for business:
1600 E HILL STREET  SIGNAL HILL, CA 90755-3682 US
Tel: 562-424-6200  Fax: 562-427-4634

Registration Information:
NPI: 1124117700
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
CAA16544
N363L00000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
CA13855

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS CA - Page 1



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