Individual
JOHN T MATTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3010 COLBY ST, 118, BERKELEY, CA 94705-2059
(800) 943-8099
(510) 845-0522
Mailing address
3010 COLBY ST, 118, BERKELEY, CA 94705-2059
(800) 943-8099
(510) 845-0522
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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