Individual
CARLO MATIBAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RRT
Contact information
Practice address
2500 MERCED ST, SAN LEANDRO, CA 94577-4201
(510) 454-1000
Mailing address
3312 SAN MARCO CT, UNION CITY, CA 94587-2704
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
26407
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A9415489
CA DL
CA
Enumeration date
12/19/2018
Last updated
12/19/2018
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