Provider Demographics
NPI:1528824653
Name:HAMBURGER, MATTHEW DAVID
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:DAVID
Last Name:HAMBURGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8749 FEATHERTOP RD
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92508-3057
Mailing Address - Country:US
Mailing Address - Phone:951-500-4627
Mailing Address - Fax:
Practice Address - Street 1:8749 FEATHERTOP RD
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92508-3057
Practice Address - Country:US
Practice Address - Phone:951-500-4627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Single Specialty