Individual
EDWIN MAUN MATIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2131 W 3RD ST, LOS ANGELES, CA 90057-1901
(213) 484-7953
(213) 413-6338
Mailing address
101 S 1ST ST, 1000, BURBANK, CA 91502-1938
(818) 845-6206
(818) 845-9774
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
—
A46416D
MEDICARE LEGACY NUMBER
CA
Enumeration date
06/30/2006
Last updated
03/27/2008
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