Provider Demographics
NPI:1386943017
Name:TATSUNO, MATTHEW GEORGE (DC)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:GEORGE
Last Name:TATSUNO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9399
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93389-9399
Mailing Address - Country:US
Mailing Address - Phone:661-322-6021
Mailing Address - Fax:661-322-9313
Practice Address - Street 1:3900 TRUXTUN AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-0600
Practice Address - Country:US
Practice Address - Phone:661-322-6021
Practice Address - Fax:661-322-9313
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-21
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30930111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor