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Individual
JOHN T MATTSON
Active
Individual
JOHN T MATTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G33079
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G330790
BLUE SHIELD
CA
05
—
00G330790
—
CA
01
—
250007310
RAILROAD MEDICARE PIN
CA
01
—
G33079
BLUE CROSS
CA
Enumeration date
07/07/2006
Last updated
05/02/2011
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