Provider Demographics
NPI:1023075108
Name:FALK, MATTHEW S (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:S
Last Name:FALK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:150 MUIR RD
Mailing Address - Street 2:VA NORTHERN CALIFORNIA HEALTH CARE SYSTEM
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-4668
Mailing Address - Country:US
Mailing Address - Phone:925-372-2124
Mailing Address - Fax:
Practice Address - Street 1:150 MUIR RD
Practice Address - Street 2:VA NORTHERN CALIFORNIA HEALTH CARE SYSTEM
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-4668
Practice Address - Country:US
Practice Address - Phone:925-372-2124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA86044207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0A8604400Medicaid
CA0A8604400Medicaid
CA0A8604400Medicare PIN