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Organization
GARY L MATSON DO INC
Active
Organization
GARY L MATSON DO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY L MATSON JR. DO (OWNER/PRESIDENT)
(858) 270-4343
Entity
Organization
Contact information
Practice address
4501 MISSION BAY DR 3E, SAN DIEGO, CA 92109
(858) 270-4343
(858) 272-1731
Mailing address
4501 MISSION BAY DR 3E, SAN DIEGO, CA 92109
(858) 270-4343
(858) 272-1731
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A6263
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX62631
—
CA
Enumeration date
05/21/2010
Last updated
05/21/2010
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