Provider Demographics
NPI:1750799771
Name:HEMMAT, MATIN R (MD)
Entity type:Individual
Prefix:DR
First Name:MATIN
Middle Name:R
Last Name:HEMMAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 DEEP VALLEY DR STE 325-A
Mailing Address - Street 2:
Mailing Address - City:ROLLING HILLS ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-3615
Mailing Address - Country:US
Mailing Address - Phone:310-265-0011
Mailing Address - Fax:800-865-5480
Practice Address - Street 1:655 DEEP VALLEY DR STE 325-A
Practice Address - Street 2:
Practice Address - City:ROLLING HILLS ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-3615
Practice Address - Country:US
Practice Address - Phone:310-265-0011
Practice Address - Fax:800-865-5480
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-23
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA133295207R00000X, 2083A0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine