Basic Information
Provider Information
NPI: 1205050614
EntityType: 2
ReplacementNPI:  
OrganizationName: OSCAR A MATTHEWS M.D.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: MISSION HEART & VASCULAR CLINIC INC
OtherOrganizationType: 4
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3156 VISTA WAY
Address2: SUITE 405
City: OCEANSIDE
State: CA
PostalCode: 920563622
CountryCode: US
TelephoneNumber: 7604396581
FaxNumber: 7604396585
Practice Location
Address1: 25470 MEDICAL CENTER DR
Address2: SUITE 201
City: MURRIETA
State: CA
PostalCode: 925624900
CountryCode: US
TelephoneNumber: 9514618800
FaxNumber: 9514618790
Other Information
ProviderEnumerationDate: 04/13/2007
LastUpdateDate: 10/14/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: MATTHEWS
AuthorizedOfficialFirstName: OSCAR
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: MEDICAL DIRECTOR
AuthorizedOfficialTelephone: 9514618800
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: M.D.
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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