Matsumoto, Bertram T
Matsumoto, Bertram T is an individual health care provider with primary practice located at 3200 S Country Club Way , Tempe AZ 85282-4054. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Matsumoto, Bertram T can be contacted via phone (480) 839-0206.Contact Information
Primary practice address
3200 S Country Club Way
Tempe AZ 85282-4054
Phone: (480) 839-0206
Fax: (480) 839-0208
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 24096 | Arizona |
Profile Details
NPI number | 1477557494 |
---|---|
LBN Legal business name | Matsumoto, Bertram T |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 8th, 2005 |
Last updated | Oct 31st, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1477557494 | NPPES |
Arizona | Other | AZ0393470 | BCBS AZ |
Arizona | MEDICAID | 358988 | BCBS AZ |
Arizona | Other | 6536800 | BCBS AZ |
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