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General NPI Number Information
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NPI Number | 1558004770
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Entity Type | Individual
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Provider Name | PATRICIA YURIEVNA MATUS DO
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Gender | Female
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Dates
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Enumeration Date | 04/15/2022
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 12677 ALCOSTA BLVD STE 240
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City | SAN RAMON
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State | CA
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Zip | 94583-4413
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Country | US
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Telephone | 925-838-6533
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Fax |
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Provider Business Mailing Address
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Address Line | 1450 TREAT BLVD STE 300
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City | WALNUT CREEK
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State | CA
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Zip | 94597-2168
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Country | US
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Telephone | 925-952-2828
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A22106
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License Number State | CA
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