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General NPI Number Information
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NPI Number | 1285764696
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Entity Type | Individual
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Provider Name | DR. JAMES MATSUBA
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Gender | Male
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 665 CAMINO DE LOS MARES STE 101
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City | SAN CLEMENTE
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State | CA
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Zip | 92673-2840
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Country | US
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Telephone | 949-496-0123
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Fax |
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Provider Business Mailing Address
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Address Line | 35254 CAMINO CAPISTRANO
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City | CAPISTRANO BEACH
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State | CA
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Zip | 92624-1802
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 25412
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License Number State | CA
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