Richard Michael Matkaluk, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

G60435 Issued in CA

Practice address

25395 Hancock Ave
Suite 230
Murrieta, CA 92562-9054

Phone

(951) 894-4100

Fax

(951) 894-4113

NPI assigned

Sep 25, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104926229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25395 HANCOCK AVE",
            "address_2": "SUITE 230",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925629054",
            "telephone_number": "951-894-4100",
            "fax_number": "951-894-4113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25395 HANCOCK AVE",
            "address_2": "SUITE 230",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925629054",
            "telephone_number": "951-894-4100",
            "fax_number": "951-894-4113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATKALUK",
        "first_name": "RICHARD",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G60435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gemaima Christa Mata, R.N
• Kylie Mata
• Amanda Mathes, RN
• Cecilia Margarita Mathews
• Merissa Anne Mathews, LCSW
• Mariah Matos
• Yara Matta, MD
• Luisa Mattaliano, LVN
• Shannon Matteson, LPCC
• Matthew R. Kanter, DDS, Inc.

• Specialist in Murrieta, CA
• Providers in Murrieta, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.