Organization
MATRIX MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE EDWARD JOHNSON JR. MD (OWNER)
(805) 541-1060
Entity
Organization
Contact information
Practice address
1304 ELLA ST., SUITE A, SAN LUIS OBISPO, CA 93401-4165
(805) 541-1060
(805) 541-6942
Mailing address
1304 ELLA ST., SUITE A, SAN LUIS OBISPO, CA 93401-4165
(805) 541-1060
(805) 541-6942
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
G29754
CA
Other
Enumeration date
12/12/2006
Last updated
08/22/2020
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