HARRY B. MATOSSIAN (NPI# 1003814229) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003814229 |
| Entity Type | Organization |
| Organization Name | HARRY B. MATOSSIAN |
| Practice Address |
234 Hospital Dr Ukiah CA 95482-4560 |
| Mailing Address |
234 Hospital Dr Suite A Ukiah CA 95482-4560 |
| Practice Telephone | 7074623190 |
| Practice Fax Number | 7074624647 |
| Mailing Telephone | 7074623190 |
| Mailing Fax Number | 7074624647 |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2014-09-23 |
| Authorized Official Name | DR. HARRY BERJ MATOSSIAN (OWNER) |
| Authorized Official Telephone | 7074623190 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
1100514 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BLUE SHIELD OF CALIFORNIA | ZZZH23012 | 01 |
| CA | MEDICARE LICENSE NUMBER | 05-C0001639 | 01 |
| CA | BLUE CROSS OF CALIFORNIA | AS1639 | 01 |
| CA | RAILROAD MEDICARE | P00117803 | 01 |
| Street Address |
234 HOSPITAL DR |
| City | UKIAH |
| State | CA |
| Zip Code | 95482-4560 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316945702 | Harry Berj Matossian | Internal Medicine | 234 Hospital Dr, Ukiah, CA 95482-4560 | 2005-07-11 |
| 1164804761 | Adventist Health Physicians Network | Internal Medicine | 234 Hospital Dr, Ukiah, CA 95482-4560 | 2015-06-19 |
| 1851682850 | Harry B Matossian, M.d. | Clinic/Center | 234 Hospital Dr, Ukiah, CA 95482-4560 | 2011-04-25 |
| 1972673895 | Renee Vinyard | Physician Assistant | 234 Hospital Dr, Ukiah, CA 95482-4560 | 2006-11-08 |
| 1710071774 | Craig A Aronchick | Internal Medicine | 234 Hospital Dr, Ukiah, CA 95482-4560 | 2006-10-03 |
| 1649384751 | Brian Patrick Hauck | Internal Medicine | 234 Hospital Dr, Ukiah, CA 95482-4560 | 2006-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932726726 | Gloria Gonzalez Campise | Midwife | 205 W. Clay Street, Ukiah, CA 95482 | 2020-06-29 |
| 1083255095 | Mendocino Care Network | Internal Medicine | 1080 N State St, Ukiah, CA 95482 | 2019-10-01 |
| 1801383153 | Costco Wholesale Corporation | Pharmacy | 1275 Airport Park Blvd., Ukiah, CA 95482 | 2018-04-21 |
| 1922528256 | Ian David Winter | Case Manager/Care Coordinator | 1120 S. Dora St, Ukiah, CA 95482 | 2017-06-27 |
| 1568917938 | Rebecca Ann Dragomani | Nurse Practitioner | 260 Hospital Dr Ste 101, Ukiah, CA 95482 | 2016-08-16 |
| 1811362536 | Manzanita Services, Inc. | Community/Behavioral Health | 410 W. Jones St., Ukiah, CA 95482 | 2015-12-07 |
| 1689061061 | Pamela Mathias | Counselor | 367 East Gobbi Street, Suite E, Ukiah, CA 95482 | 2015-04-23 |
| 1275927030 | Jack David Segel | Counselor | 564 Dora St., Ste.d, Ukiah, CA 95482 | 2015-03-19 |
| 1689070211 | Mendocino County Youth Project | Clinic/Center | 347 Plum St, #b, Ukiah, CA 95482 | 2014-11-10 |
| 1346649951 | Ae Ran Ku | Dentist | 1096 South Dora Street, Ukiah, CA 95482 | 2014-08-19 |
| Find all providers in zip 95482 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790969301 | Pavilion Surgical Services LLC | Clinic/Center | 245 Hospital Dr., 100, Ukiah, CA 95482 | 2007-12-19 |
| 1851682850 | Harry B Matossian, M.d. | Clinic/Center | 234 Hospital Dr, Ukiah, CA 95482-4560 | 2011-04-25 |
| 1083944375 | Observatory Surgery Center LLC. | Clinic/Center | 271 Observatory Ave, Ukiah, CA 95482-5757 | 2010-01-08 |
| 1568428456 | Ukiah Surgery Center Lp | Clinic/Center | 271 Observatory Ave, Ukiah, CA 95482-5757 | 2006-04-21 |
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| 1366041469 | The Regents of The University of California | Clinic/Center | 4343 Lankershim Blvd Ste 210, North Hollywood, CA 91602-2705 | 2020-10-20 |
| 1609473420 | Alden Advanced Surgicenter LLC | Clinic/Center | 8741 Alden Drive, Suite B, Los Angeles, CA 90048 | 2020-10-05 |
| 1396352944 | Irvine Surgical Center LLC | Clinic/Center | 17624 Redhill Ave Ste B, Irvine, CA 92614 | 2020-09-28 |
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| 1003420001 | On Beach Surgery Center, LLC | Clinic/Center | 5832 Beach Blvd, Suite 210, Buena Park, CA 90621 | 2020-09-07 |
| 1811501661 | Precision Surgical Arts | Clinic/Center | 20311 Sw Birch St Ste 201, Newport Beach, CA 92660-1777 | 2020-08-31 |
| 1205448750 | Elite Surgery Center of South Bay LLC | Clinic/Center | 20528 Hawthorne Blvd Ste 301, Torrance, CA 90503-3202 | 2020-08-17 |
| 1740891571 | Peninsula Surgery Center, LLC | Clinic/Center | 350 Marine Pkwy Ste 100, Redwood City, CA 94065-5224 | 2020-08-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.