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General NPI Number Information
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NPI Number | 1679223663
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Entity Type | Organization
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Legal Business Name | ADVENTIST FAMILY MEDICINE RESIDENCY TULARE
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Dates
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Enumeration Date | 03/24/2022
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Last Update Date | 03/29/2022
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Provider Practice Location Address
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Address Line | 2059 HILLMAN ST
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City | TULARE
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State | CA
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Zip | 93274-1609
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Country | US
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Telephone | 559-605-0090
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Fax |
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Provider Business Mailing Address
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Address Line | 2059 HILLMAN ST
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City | TULARE
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State | CA
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Zip | 93274-1609
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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 | RESIDENT PHYSICIAN
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Name | PATRICK A MATIAN
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Credential | DO
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Telephone | 408-332-9879
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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 |
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License Number State |
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