Organization
MAVIS N MATSUMOTO, MD, LLC
Active
Parent organization
MAVIS N MATSUMOTO, MD, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MAVIS N MATSUMOTO, MD, LLC
Authorized official
DR. MAVIS MATSUMOTO M.D. (OWNER)
(702) 992-4050
Entity
Organization
Contact information
Practice address
2780 W HORIZON RIDGE PKWY, SUITE 30, HENDERSON, NV 89052-3995
(702) 992-4050
Mailing address
2980 N BEVERLY GLEN CIR, SUITE 301, LOS ANGELES, CA 90077-1726
(310) 474-9809
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
12/08/2011
Last updated
04/15/2013
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