Provider Demographics
NPI:1417516444
Name:MATRIX CLINICAL RESEARCH
Entity Type:Organization
Organization Name:MATRIX CLINICAL RESEARCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, SITE OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:STAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GERSHOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-424-5922
Mailing Address - Street 1:1919 W 7TH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-4103
Mailing Address - Country:US
Mailing Address - Phone:310-424-5922
Mailing Address - Fax:323-983-4646
Practice Address - Street 1:1919 W 7TH ST FL 2
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-4103
Practice Address - Country:US
Practice Address - Phone:310-424-5922
Practice Address - Fax:323-983-4646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-12
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty