OrganizationActive
Mavis N Matsumoto, MD, LLC
NPI 1902174741 · Non-Pharmacy Dispensing Site · Henderson, NV
Provider details
- NPI number
- 1902174741
- Entity type
- Organization
- Primary specialty
- Non-Pharmacy Dispensing SiteSuppliers
- Parent organization
- Mavis N Matsumoto, MD, LLC
- Organization subpart
- Yes
- Authorized official
- Mavis Matsumoto, Owner(702) 992-4050
Specialties & taxonomies
Suppliers
Practice location
2780 W Horizon Ridge Pkwy
Suite 30
Henderson, NV 89052-3995
Phone: (702) 992-4050
Approximate (ZIP-level) locationGet directions
Mailing address
2980 N Beverly Glen Cir
Los Angeles, CA 90077-1726
Registry dates
- Enumerated
- 2011-12-08
- Last updated
- 2013-04-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.