Matrix Medical Corporation

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

G29754 Issued in CA

Legal business name

MATRIX MEDICAL CORPORATION

Practice address

1304 Ella St.
Suite a
San Luis Obispo, CA 93401-4165

Phone

(805) 541-1060

Fax

(805) 541-6942

NPI assigned

Dec 12, 2006

Organization subpart

No

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

Authorized official

Name

George Edward Johnson Jr., MD

Title

Owner

Phone

(805) 541-1060

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770644239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 ELLA ST.",
            "address_2": "SUITE A",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014165",
            "telephone_number": "805-541-1060",
            "fax_number": "805-541-6942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 ELLA ST.",
            "address_2": "SUITE A",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014165",
            "telephone_number": "805-541-1060",
            "fax_number": "805-541-6942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATRIX MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-541-1060",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G29754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Masters
• Maria C Masullo
• Carlin Joy Matejka, ACSW 123506
• Michael Eugene Mathes, LVN, AEMT
• Dan Matich
• Rory Matson, ED.S.
• Matthew Kilthau MD Medical Corporation
• Summer Matthews, BS, CMT
• Malia Mattox
• Jonathan Maule, MS, MA, MFA

• Obstetrics & Gynecology Physician in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.