Basic Information
Provider Information
NPI: 1497950455
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DOWLING
FirstName: MATTHEW
MiddleName: SEAN
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8810 RIO SAN DIEGO DR
Address2: VA MISSION VALLEY CLINIC
City: SAN DIEGO
State: CA
PostalCode: 921081698
CountryCode: US
TelephoneNumber: 6194005050
FaxNumber: 6194005055
Practice Location
Address1: 8810 RIO SAN DIEGO DR
Address2: VA MISSION VALLEY CLINIC
City: SAN DIEGO
State: CA
PostalCode: 921081698
CountryCode: US
TelephoneNumber: 6194005050
FaxNumber: 6194005055
Other Information
ProviderEnumerationDate: 06/19/2007
LastUpdateDate: 09/30/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XC138777CAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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