Matney, Glenn Paul

Matney, Glenn Paul is an sole proprietor health care provider with primary practice located at 12402 Industrial Blvd Ste B1 , Victorville CA 92395-5889. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Addiction Psychiatry, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Matney, Glenn Paul can be contacted via phone (760) 245-9363.

Contact Information

Primary practice address
12402 Industrial Blvd Ste B1 Victorville CA 92395-5889
Phone: (760) 245-9363
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 207QA0401X G069064 California
Allopathic & Osteopathic Physicians / Addiction Medicine 2084A0401X G069064 California
Allopathic & Osteopathic Physicians / Addiction Psychiatry 2084P0802X G69064 California
Allopathic & Osteopathic Physicians / Pediatrics 208000000X G069064 California

Profile Details

NPI number 1902822059
LBN Legal business name Matney, Glenn Paul
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 14th, 2006
Last updated Aug 10th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902822059 NPPES
California MEDICAID 00G690641 8757126

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