MARK ELLIOTT MATUSAK

LOS ANGELES, CA
NPI1942706056
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207QS0010X Family Medicine, Sports Medicine
(Licence: CA  20A18824)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2018-04-05
Last Update Date2021-08-06
Business Address
MARK ELLIOTT MATUSAK
6801 PARK TER STE 400
LOS ANGELES, CA 90045-9212
Phone number: 310-665-7200
Mailing Address
MARK ELLIOTT MATUSAK
1100 DELAPLAINE CT
MADISON, WI 53715-1840
Phone number: 608-263-4550