# HARRY B. MATOSSIAN

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003814229
- **Authorized official:** DR. HARRY BERJ MATOSSIAN M.D. (OWNER)
- **Authorized official phone:** (707) 462-3190

## Contact information

- **Practice address:** 234 HOSPITAL DR, UKIAH, CA 95482-4560
- **Practice address phone:** (707) 462-3190
- **Practice address fax:** (707) 462-4647
- **Mailing address:** 234 HOSPITAL DR, SUITE A, UKIAH, CA 95482-4560
- **Mailing address phone:** (707) 462-3190
- **Mailing address fax:** (707) 462-4647

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 1100514 | CA | Yes |

## Other

- **Enumeration date:** 07/12/2005
- **Last updated:** 09/23/2014