Individual
HARRY BERJ MATOSSIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
234 HOSPITAL DR, UKIAH, CA 95482-4560
(707) 462-0681
(707) 462-4647
Mailing address
234 HOSPITAL DR, UKIAH, CA 95482-4560
(707) 462-0681
(707) 462-4647
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
G62323
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G623230
—
CA
01
—
ZZZ56549Z
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
07/11/2005
Last updated
08/26/2024
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