Provider Demographics
NPI:1528515731
Name:MATHEWS, DAVID (LAADC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:MATHEWS
Suffix:
Gender:M
Credentials:LAADC
Other - Prefix:
Other - First Name:DAVID
Other - Middle Name:
Other - Last Name:MATTHEWS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:123 S MONTEBELLO BLVD
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-4729
Mailing Address - Country:US
Mailing Address - Phone:323-887-7900
Mailing Address - Fax:
Practice Address - Street 1:123 S MONTEBELLO BLVD
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-4729
Practice Address - Country:US
Practice Address - Phone:949-867-0987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-06
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)