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General NPI Number Information
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NPI Number | 1326348814
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Entity Type | Organization
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Legal Business Name | DCM ANESTHESIA A PROFESSIONAL
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Dates
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Enumeration Date | 10/29/2010
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Last Update Date | 04/01/2019
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Provider Practice Location Address
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Address Line | 701 E 28TH ST STE 300
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City | LONG BEACH
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State | CA
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Zip | 90806-2776
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Country | US
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Telephone | 714-521-9703
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Fax | 714-312-5864
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Provider Business Mailing Address
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Address Line | 5267 WARNER AVE #309
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92649-4079
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Country | US
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Telephone | 562-493-2225
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RAAFAT MATTAR
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Credential | M.D.
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Telephone | 562-493-2225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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