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NPI Code Detail

MEDICARE: DR. NADER MATLOUBI M.D

MEDICARE:  DR. NADER  MATLOUBI  M.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician036-108962IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578770806
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NADER MATLOUBI M.D
Provider Business Mailing Address
First Line : 12677 HESPERIA RD STE 190
Second Line :
City : VICTORVILLE
State : CA
Zip : 92395-7754
Country : US
Telephone Number : 760-243-1234
Fax Number : 708-223-8730
Provider Business Practice Location Address
First Line : 12818 HEACOCK ST STE C2
Second Line :
City : MORENO VALLEY
State : CA
Zip : 92553-3173
Country : US
Telephone Number : 951-242-2508
Fax Number : 951-242-2548
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2007
Last Update Date : 09/03/2019

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Directions to “ DR. NADER MATLOUBI M.D” Practice Location

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