Basic Information
| Provider Information | |||||||||
| NPI: | 1922395490 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RILEY | ||||||||
| FirstName: | MATTHEW | ||||||||
| MiddleName: | H | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 450 STANYAN ST. | ||||||||
| Address2: | ROOM 503 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94117 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4157505909 | ||||||||
| FaxNumber: | 4157505910 | ||||||||
| Practice Location | |||||||||
| Address1: | 450 STANYAN ST. | ||||||||
| Address2: | ROOM 503 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94117 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4157505909 | ||||||||
| FaxNumber: | 4157505910 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2011 | ||||||||
| LastUpdateDate: | 05/17/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 20A13448 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.