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:
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Health care specialties

SpecialtyCodeLicense #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 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477557494 NPPES
Arizona Other AZ0393470 BCBS AZ
Arizona MEDICAID 358988 BCBS AZ
Arizona Other 6536800 BCBS AZ

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