Mavis N Matsumoto, Md, Llc | |
870 Seven Hills Dr Suite 102 Henderson NV 89052-4377 | |
(702) 992-4050 | |
(702) 992-4052 |
Full Name | Mavis N Matsumoto, Md, Llc |
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Speciality | Clinic/Center |
Location | 870 Seven Hills Dr, Henderson, Nevada |
Authorized Official Name and Position | Mavis N Matsumoto (OWNER) |
Authorized Official Contact | 7029924050 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Mavis N Matsumoto, Md, Llc 870 Seven Hills Dr Suite 102 Henderson NV 89052-4377 Ph: (702) 992-4050 | Mavis N Matsumoto, Md, Llc 870 Seven Hills Dr Suite 102 Henderson NV 89052-4377 Ph: (702) 992-4050 |
NPI Number | 1932497229 |
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Provider Enumeration Date | 07/20/2011 |
Last Update Date | 04/13/2012 |
Medicare PECOS PAC ID | 6800065012 |
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Medicare Enrollment ID | O20110804000272 |
Identifier | Type | State | Issuer |
---|---|---|---|
1932497229 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | 7825 (Nevada) | Primary |
Provider Name | Mavis N Matsumoto |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1942213558 PECOS PAC ID: 2769651975 Enrollment ID: I20110804000339 |
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