Individual
DR. MAVIS N MATSUMOTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2780 W HORIZON RIDGE PKWY, SUITE 30, HENDERSON, NV 89052-3995
(702) 992-4050
(702) 992-4052
Mailing address
PO BOX 530656, HENDERSON, NV 89053-0656
(702) 992-4050
(702) 992-4052
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
7825
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2019816
—
NV
Enumeration date
08/14/2006
Last updated
03/22/2016
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