Individual
DR. PHILIP MATIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8782 BRONSON DR, GRANITE BAY, CA 95746-6907
(916) 791-1947
Mailing address
PO BOX 2609, GRANITE BAY, CA 95746-2609
(916) 791-1947
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
G15173
CA
207UN0903X
In Vivo & In Vitro Nuclear Medicine Physician
Primary
G15173
CA
Other
Enumeration date
11/09/2010
Last updated
11/09/2010
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