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GARY L MATSON DO INC NPI 1225357833


NPI Information

NPI: 1225357833
Provider Name: GARY L MATSON DO INC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 05D0570186

Address:
4501 MISSION BAY DR 3E
SAN DIEGO, CA
ZIP 92109
Phone: (858) 270-4343
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GARY L MATSON DO INC is a family medicine in San Diego, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. GARY L MATSON DO INC NPI is 1225357833. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4501 MISSION BAY DR 3E
SAN DIEGO, CA
ZIP 92109
Phone: (858) 270-4343
Fax: (858) 272-1731

The provider's authorized official is Gary L Matson .
The authorized official title is Owner/president and has the following contact phone number (858) 270-4343.

The CLIA number assigned to this NPI record is 05D0570186 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 5/21/2010 and was last updated on 5/21/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine20A6263CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1F75512MEDICARE UPINCALIFORNIA
200AX62631MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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