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General NPI Number Information
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NPI Number | 1578770806
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Entity Type | Individual
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Provider Name | NADER MATLOUBI M.D
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Gender | Male
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 09/03/2019
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Provider Practice Location Address
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Address Line | 12818 HEACOCK ST STE C2
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City | MORENO VALLEY
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State | CA
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Zip | 92553-3173
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Country | US
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Telephone | 951-242-2508
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Fax | 951-242-2548
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Provider Business Mailing Address
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Address Line | 12677 HESPERIA RD STE 190
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City | VICTORVILLE
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State | CA
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Zip | 92395-7754
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Country | US
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Telephone | 760-243-1234
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Fax | 708-223-8730
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 036-108962
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License Number State | IL
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