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General NPI Number Information
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NPI Number | 1952218653
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Entity Type | Organization
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Legal Business Name | AJ MATTIS MD INC
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Dates
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Enumeration Date | 08/26/2026
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Last Update Date | 08/26/2026
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Provider Practice Location Address
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Address Line | 38600 MEDICAL CENTER DR
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City | PALMDALE
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State | CA
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Zip | 93551-4483
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Country | US
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Telephone | 818-209-4430
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Fax |
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Provider Business Mailing Address
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Address Line | 1132 LAVENDER LN
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City | LA CANADA
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State | CA
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Zip | 91011-2339
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Country | US
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Telephone | 818-209-4430
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AIDAS JOSEPH MATTIS
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Credential | MD, PHD
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Telephone | 818-209-4430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number |
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License Number State |
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