| Matthew Kollefrath, M.d., Inc. | |
|
435 N Roxbury Dr Ste 300 Beverly Hills CA 90210-5005 | |
| (310) 550-7421 | |
| (310) 388-0915 |
| Full Name | Matthew Kollefrath, M.d., Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 435 N Roxbury Dr Ste 300, Beverly Hills, California |
| Authorized Official Name and Position | Matthew Kollefrath (PRESIDENT/OWNER) |
| Authorized Official Contact | 3105507421 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Matthew Kollefrath, M.d., Inc. 435 N Roxbury Dr Ste 300 Beverly Hills CA 90210-5005 Ph: (310) 550-7421 | Matthew Kollefrath, M.d., Inc. 435 N Roxbury Dr Ste 300 Beverly Hills CA 90210-5005 Ph: (310) 550-7421 |
| NPI Number | 1730952623 |
|---|---|
| Provider Enumeration Date | 11/01/2023 |
| Last Update Date | 08/06/2024 |
| Medicare PECOS PAC ID | 4688024532 |
|---|---|
| Medicare Enrollment ID | O20231219001762 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730952623 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Matthew Blake Kollefrath |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568998516 PECOS PAC ID: 4385068394 Enrollment ID: I20200723002037 |
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