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Matthew David Fukuda

Emergency Medicine

Allopathic & Osteopathic Physicians

4445 Magnolia Ave, Riverside, CA 92501-4135

PECOS Enrollment

This provider is enrolled in PECOS as MATTHEW FUKUDA.

Based on the most recent information from CMS, provider Matthew David Fukuda 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 2 days ago.

Profile Details

Provider ID
1285262535
Provider Type
Individual
Full Name
Fukuda, Matthew David
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
3/31/2020
Last Updated
8/16/2024

Contact Information

Practice Location

4445 Magnolia Ave, Riverside, CA 92501-4135

(951) 788-3124

Unlisted Fax

Mailing Location

4445 Magnolia Ave, Riverside, CA 92501-4135

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207P00000X Primary	Description Emergency Medicine Allopathic & Osteopathic Physicians	License MD61375710 Washington

Matthew David Fukuda

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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Hu, Jeffrey

Pandya, Devan Sanjay

Schoenberg, Benjamen Elliot

Agudelo, Adrian Zabdiel

Raney, Emerald

Kong, Erwin

Ghassemzadeh, Sassan

Hadyah, Sana

Ng, Daniel