Provider Demographics
NPI:1326348814
Name:DCM ANESTHESIA A PROFESSIONAL
Entity Type:Organization
Organization Name:DCM ANESTHESIA A PROFESSIONAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAAFAT
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-493-2225
Mailing Address - Street 1:5267 WARNER AVE
Mailing Address - Street 2:#309
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92649-4079
Mailing Address - Country:US
Mailing Address - Phone:562-493-2225
Mailing Address - Fax:
Practice Address - Street 1:701 E 28TH ST STE 300
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2776
Practice Address - Country:US
Practice Address - Phone:714-521-9703
Practice Address - Fax:714-312-5864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-29
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty