Organization
SIERRA HOUSECALLS MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW L PERSONIUS M.D. (OWNER/PRESIDENT)
(209) 532-4287
Entity
Organization
Contact information
Practice address
183 FAIRVIEW LN, SUITE C, SONORA, CA 95370-4856
(209) 532-4287
Mailing address
183 FAIRVIEW LN, SUITE C, SONORA, CA 95370-4856
(209) 532-4287
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
364SG0600X
Gerontology Clinical Nurse Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DA1747
MEDICARE RAILROAD
CA
Enumeration date
07/05/2006
Last updated
04/11/2008
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