Organization
EDWIN MATIAS, M.D., A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWIN MAUN MATIAS M.D. (PRESIDENT)
(626) 795-6596
Entity
Organization
Contact information
Practice address
2131 W 3RD ST, LOS ANGELES, CA 90057-1901
(213) 484-7953
(213) 413-6338
Mailing address
225 S LAKE AVE, 535, PASADENA, CA 91101-3005
(626) 795-6596
(626) 795-8247
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A46461
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A464160
BLUE SHIELD
CA
05
—
00A464160
—
CA
01
—
2411535
MEDICAL PIN
CA
01
—
W18933
GRUOP MCR
CA
Enumeration date
09/22/2006
Last updated
03/27/2008
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