Matusak, Mark Elliott
Matusak, Mark Elliott is an individual health care provider with primary practice located at 6801 Park Ter Ste 400 , Los Angeles CA 90045-9212. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Matusak, Mark Elliott can be contacted via phone (310) 665-7200.Contact Information
Primary practice address
6801 Park Ter Ste 400
Los Angeles CA 90045-9212
Phone: (310) 665-7200
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
Allopathic & Osteopathic Physicians / Sports Medicine | 207QS0010X | 20A18824 | California |
Profile Details
NPI number | 1942706056 |
---|---|
LBN Legal business name | Matusak, Mark Elliott |
Credentials | |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Apr 5th, 2018 |
Last updated | Aug 6th, 2021 - about 3 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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