Organization Name: | MATTEO R MUTI,JR |
NPI Number: | 1679878771 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MATTEO RENATO MUTI (PRE4SIDENT/PSYCHOLOIST) |
Mailing Address: | 12214 Riverside Dr Valley Village |
State: | CA US |
Postal Code: | 916073830 |
Phone Number: | 8187631212 |
Fax Number: | |
NPI Enumeration Date: | 01/20/2011 |
NPI Last Update Date: | 01/20/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251K00000X |
License Number: | 004454 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Public Health or Welfare |
Taxonomy Specialization: | |
Taxonomy Definition: |