Individual
DR. ROGER MATEOSSIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
489
ID
152W00000X
Optometrist
CA5302
CA
152W00000X
Optometrist
Primary
NV126
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00244142
RAILROAD MEDICARE
—
Enumeration date
10/26/2006
Last updated
12/07/2007
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