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Matthew Alan Mccullough

Internal Medicine

Allopathic & Osteopathic Physicians

27235 Tourney Rd Ste 2500, Valencia, CA 91355-5908

PECOS Enrollment

This provider is enrolled in PECOS as MATTHEW MCCULLOUGH.

Based on the most recent information from CMS, provider Matthew Alan Mccullough is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records today at 10:04 AM.

Profile Details

Provider ID
1679839732
Provider Type
Individual
Full Name
Mccullough, Matthew Alan
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
4/3/2012
Last Updated
2/4/2022

Contact Information

Practice Location

27235 Tourney Rd Ste 2500, Valencia, CA 91355-5908

(661) 253-5851

(661) 535-5852

Mailing Location

5767 W Century Blvd Suite 400, Los Angeles, CA 90095-5631

(310) 301-8707

(310) 301-8751

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License A128263 California

Matthew Alan Mccullough

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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