Muhammad A Mattu, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

A29499 Issued in CA

Practice address

1908 Coffee Rd Ste 3
Modesto, CA 95355-2719

Phone

(209) 846-9429

NPI assigned

Jun 20, 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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537488000000",
    "number": "1225073307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1908 COFFEE RD STE 3",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552719",
            "telephone_number": "209-846-9429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1908 COFFEE RD STE 3",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552719",
            "telephone_number": "209-846-9429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTU",
        "first_name": "MUHAMMAD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2018-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A29499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COUNTY OF MONTEREY NMC",
            "identifier": "94-6000524",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP40248F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diane Renee Matthews, RN, PHN
• Justin Mattiuzzo, OTR/L
• Aliesha Angelina Mattos
• Makenzie Mattos
• Natalie Angele Mattos, PA
• Laurie Mauldin, FNP
• Maulik Shah Dental Corporation
• Lissette Leilani Maunakea
• Carley Lynne Maurer
• Emma Maurer

• Cardiovascular Disease Physician in Modesto, CA
• Providers in Modesto, CA by specialty
• Cardiovascular Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.