Individual provider Active NPI

Robert John Matutat, PHARM.D.

  • Pharmacist
  • San Francisco, CA
National Provider Identifier
1912284613
Registry record updated Nov 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
31157 Issued in CA
Practice address
58 W Portal Ave
No. 182
San Francisco, CA 94127-1304
Phone
(415) 699-2253
Fax
(415) 869-3920
NPI assigned
Nov 8, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 31157 CA Primary

Addresses

Primary practice location

58 W Portal Ave
No. 182
San Francisco, CA 94127-1304

Mailing address

58 W Portal Ave
No. 182
San Francisco, CA 94127-1304
Phone (415) 699-2253

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

NPI Registry JSON

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

{
    "created_epoch": "1320710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320710400000",
    "number": "1912284613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 W PORTAL AVE",
            "address_2": "NO. 182",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941271304",
            "telephone_number": "415-699-2253",
            "fax_number": "415-869-3920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 W PORTAL AVE",
            "address_2": "NO. 182",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941271304",
            "telephone_number": "415-699-2253",
            "fax_number": "415-869-3920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATUTAT",
        "first_name": "ROBERT",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-08",
        "last_updated": "2011-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "31157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; 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.