Healthcare Provider Details

I. General information

NPI: 1508524083
Provider Name (Legal Business Name): MATHIAS PRIMARY CARE ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2021
Last Update Date: 02/14/2022
Certification Date: 02/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

391 N SAN JACINTO ST
HEMET CA
92543-3118
US

IV. Provider business mailing address

391 N SAN JACINTO ST
HEMET CA
92543-3118
US

V. Phone/Fax

Practice location:
  • Phone: 951-533-5123
  • Fax: 951-929-9786
Mailing address:
  • Phone: 951-533-5123
  • Fax: 951-929-9786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HERMAN MATHIAS
Title or Position: PRESIDENT
Credential: M.D
Phone: 951-533-5123