Mousa Matar MD INC
Internal Medicine in Riverside, CA. Organization (NPI-2).
Details
- NPI
- 1558094904
- Entity type
- Organization (NPI-2)
- Legal business name
- Mousa Matar MD INC
- Organization subpart
- Yes
- Enumeration date
- Jul 5, 2022
- Certification date
- Feb 20, 2023
- Last updated
- Feb 20, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
Practice location
4440 Brockton Ave Ste 100Riverside, CA 92501-4026
Phone 773-814-8200 · Fax 951-788-6380
Mailing address
Po Box 1810Upland, CA 91785-1810
Phone 773-814-8200 · Fax 951-750-1091
Other practice locations
Riverside, CA 92506-2930
Phone 951-788-8332 · Fax 951-788-6380
Authorized official
Mousa Matar
MD
7738148200
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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