Provider Demographics
NPI:1134139918
Name:MATUK, AILEEN R (MD)
Entity Type:Individual
Prefix:DR
First Name:AILEEN
Middle Name:R
Last Name:MATUK
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2323 16TH ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-3420
Mailing Address - Country:US
Mailing Address - Phone:661-327-8651
Mailing Address - Fax:661-327-2703
Practice Address - Street 1:2323 16TH ST
Practice Address - Street 2:SUITE 500
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3420
Practice Address - Country:US
Practice Address - Phone:661-327-8651
Practice Address - Fax:661-327-2703
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2024-04-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA24584207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA24037Medicare UPIN