Individual provider · Type 1 NPI
Matthew Civilette
General Practice Physician · Coronado, CA
NPI number
1053069724
Active
Practice location
601 Mccain Blvd.
Coronado, CA 92118
Mailing address
601 Mccain Blvd
Coronado, CA 92118
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | None listed |
| General Practice Physician Primary | 208D00000X | 0101279134 (VA) |
General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Other general practice physician providers in Coronado
About NPI 1053069724
Matthew Civilette's National Provider Identifier is 1053069724, issued on Mar 12, 2022. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Coronado, CA. The record was last updated on Mar 14, 2024.