MEDICARE: RAAFAT MATTAR, MD, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208VP0014X	Interventional Pain Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477714996
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAAFAT MATTAR, MD, INC.

Provider Business Mailing Address
First Line	:	18800 DELAWARE ST STE 630
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92648-6099
Country	:	US
Telephone Number	:	714-521-9703
Fax Number	:	714-312-5864

Provider Business Practice Location Address
First Line	:	18800 DELAWARE ST STE 630
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92648-6099
Country	:	US
Telephone Number	:	714-521-9703
Fax Number	:	714-312-5864

Authorized Official
Title or Position	:	OWNER
Name	:	MR. RAAFAT MATTAR
Credential	:	M.D.
Telephone Number	:	714-580-8990

Provider Enumeration Date	:	06/18/2008
Last Update Date	:	01/29/2025

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