Individual
ELLEN REIKO MATSUMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
4650 W SUNSET BLVD, MS# 88, LOS ANGELES, CA 90027-6062
(323) 361-2344
(323) 666-6283
Mailing address
6430 W SUNSET BLVD, SUITE 600, LOS ANGELES, CA 90028-7901
(323) 361-2337
(323) 361-8491
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
OPT6291
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0062910
—
CA
Enumeration date
09/27/2006
Last updated
01/10/2008
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