MEDICARE: MATIN MEDICINE, INC.

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
1	261QP2300X	Primary Care Clinic/Center
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1689564296
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MATIN MEDICINE, INC.

Provider Business Mailing Address
First Line	:	1218 HIGHLAND AVE
Second Line	:
City	:	MANHATTAN BEACH
State	:	CA
Zip	:	90266-4718
Country	:	US
Telephone Number	:	323-391-7686
Fax Number	:

Provider Business Practice Location Address
First Line	:	1218 HIGHLAND AVE
Second Line	:
City	:	MANHATTAN BEACH
State	:	CA
Zip	:	90266-4718
Country	:	US
Telephone Number	:	323-391-7686
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	TAHMORES MATIN
Credential	:	MD
Telephone Number	:	310-896-5208

Provider Enumeration Date	:	07/07/2025
Last Update Date	:	07/25/2025

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Directions to “MATIN MEDICINE, INC. ” Practice Location

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