Provider Demographics
NPI:1609908565
Name:MATULA, SIERRA R (MD)
Entity Type:Individual
Prefix:DR
First Name:SIERRA
Middle Name:R
Last Name:MATULA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UCSF DEPT OF SURGERY
Mailing Address - Street 2:513 PARNASSUS AVE, S321
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-0001
Mailing Address - Country:US
Mailing Address - Phone:415-260-3186
Mailing Address - Fax:
Practice Address - Street 1:1001 PORTERO AVE, WARD 3A
Practice Address - Street 2:DEPT SURGERY
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114
Practice Address - Country:US
Practice Address - Phone:415-206-4627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA98316208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery