Provider Demographics
NPI:1881874691
Name:MATIAS, BELEN ALEDIA (MD)
Entity type:Individual
Prefix:DR
First Name:BELEN
Middle Name:ALEDIA
Last Name:MATIAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:17075 DEVONSHIRE ST
Mailing Address - Street 2:SUITE# 305
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-1600
Mailing Address - Country:US
Mailing Address - Phone:818-363-0110
Mailing Address - Fax:818-363-0160
Practice Address - Street 1:17075 DEVONSHIRE ST
Practice Address - Street 2:SUITE# 305
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-1600
Practice Address - Country:US
Practice Address - Phone:818-363-0110
Practice Address - Fax:818-363-0160
Is Sole Proprietor?:No
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA056439207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A564390Medicaid
CA00A564390Medicaid
CAA56439AMedicare PIN