# JERRY MATSUMURA MD, INC. A PROFESSIONAL CORPORATION

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

## Provider details

- **NPI number:** 1962455907
- **Authorized official:** JERRY S. MATSUMURA MD (PRESIDENT)
- **Authorized official phone:** (801) 993-9534

## Contact information

- **Practice address:** 18124 WEDGE PKWY STE 232, RENO, NV 89511-8134
- **Practice address phone:** (801) 993-9534
- **Practice address fax:** (775) 853-2728
- **Mailing address:** 18124 WEDGE PKWY STE 232, RENO, NV 89511-8134
- **Mailing address phone:** (801) 993-9534
- **Mailing address fax:** (775) 853-2728

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | 7899 | NV | Yes |

## Other

- **Enumeration date:** 05/19/2006
- **Last updated:** 02/01/2008