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Individual

MATTHEW PAUL TUCKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
4867 W SUNSET BLVD, LOS ANGELES, CA 90027-5969
(913) 461-9677
Mailing address
617 CABRILLO VILLAS, LOS ANGELES, CA 90042-5015

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
2019043388
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
95001019
CA

Other

Enumeration date
12/27/2018
Last updated
05/02/2025
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