MEDICARE: DR. ROBERT JOHN MATYAS II D.O.

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	207Q00000X	Family Medicine Physician	20A11040	CA

General Provider Information

NPI Number	:	1578543831
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT JOHN MATYAS II D.O.

Provider Business Mailing Address
First Line	:	4450 AGNES AVE
Second Line	:
City	:	STUDIO CITY
State	:	CA
Zip	:	91607-4103
Country	:	US
Telephone Number	:	808-388-1345
Fax Number	:

Provider Business Practice Location Address
First Line	:	4450 AGNES AVE
Second Line	:
City	:	STUDIO CITY
State	:	CA
Zip	:	91607-4103
Country	:	US
Telephone Number	:	808-388-1345
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/20/2006
Last Update Date	:	02/20/2025

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