Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1306989686 |
---|---|
Provider Name | Dr. Tamer Mattar |
First Address | Los Angeles, CA 90057-3801 |
Second Address | Los Angeles, CA 90057-3801 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 18/07/2011 |