Matkovich, Lydia
Matkovich, Lydia is an individual health care provider with primary practice located at 23600 Telo Ave Suite 210, Torrance CA 90505-4035. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Glaucoma Specialist, Allopathic & Osteopathic Physicians / Ophthalmology. Allopathic & Osteopathic Physicians / Ophthalmology is her primary health care specialty. Matkovich, Lydia can be contacted via phone (310) 626-8055.Contact Information
Primary practice address
23600 Telo Ave Suite 210
Torrance CA 90505-4035
Phone: (310) 626-8055
Fax: (310) 626-8058
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Glaucoma Specialist | 207WX0009X | G80774 | California |
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | G80774 | California |
Profile Details
| NPI number | 1508801028 |
|---|---|
| LBN Legal business name | Matkovich, Lydia |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 18th, 2006 |
| Last updated | Nov 21st, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508801028 | NPPES |
| California | Other | 00G807740 | BLUE SHIELD |
| California | MEDICAID | 00G807740 | BLUE SHIELD |
| California | Other | P00286193 | BLUE SHIELD |
| California | MEDICAID | 00G807741 | BLUE SHIELD |
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