HARRY B. MATOSSIAN
Surgery Yellow Pages
Ukiah, California
Provider NPI: 1003814229
Organization Information:Organization Name: HARRY B. MATOSSIAN
Practice Location:
234 HOSPITAL DR UKIAH, CA 95482 US
Tel: 707-462-3190 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
234 HOSPITAL DR UKIAH, CA 95482 US
Tel: 707-462-3190 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 261QA1903X | Ambulatory Health Care Facilities Clinic/Center Ambulatory Surgical | CA | 1100514 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
BLUE SHIELD OF CALIFORNIA | ZZZH23012 | CA | 01 |
MEDICARE LICENSE NUMBER | 05-C0001639 | CA | 01 |
BLUE CROSS OF CALIFORNIA | AS1639 | CA | 01 |
RAILROAD MEDICARE | P00117803 | CA | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin