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Organization
MARVIN P MATLOCK M D INC
Active
Organization
MARVIN P MATLOCK M D INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARVIN PERRY MATLOCK M.D. (OWNER)
(559) 226-7107
Entity
Organization
Contact information
Practice address
125 E BARSTOW AVE, SUITE 104, FRESNO, CA 93710-5020
(559) 226-7107
Mailing address
125 E BARSTOW AVE, SUITE 104, FRESNO, CA 93710-5020
(559) 226-7107
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G30634
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P0017327
RAILROAD MEDICARE
CA
Enumeration date
12/22/2008
Last updated
03/20/2009
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