Individual
LARRY MATSUMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2105 FOREST AVE, SAN JOSE, CA 95128-1425
(408) 947-2501
(408) 283-7745
Mailing address
PO BOX 2311, CHATSWORTH, CA 91313-2311
(818) 718-9500
(818) 718-9507
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
G25060
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G250600
—
CA
Enumeration date
09/12/2005
Last updated
07/08/2007
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