Basic Information
| Provider Information | |||||||||
| NPI: | 1073694378 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MATING | ||||||||
| FirstName: | NARWHALS | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SPISAK | ||||||||
| OtherFirstName: | RAYMOND | ||||||||
| OtherMiddleName: | REX | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 305 EAST CENTER AVE. | ||||||||
| Address2: | |||||||||
| City: | VISALIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932916331 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5597374700 | ||||||||
| FaxNumber: | 5597374782 | ||||||||
| Practice Location | |||||||||
| Address1: | 35800 HIGHWAY 190 | ||||||||
| Address2: | |||||||||
| City: | SPRINGVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932659116 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5595392324 | ||||||||
| FaxNumber: | 5595392923 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/17/2006 | ||||||||
| LastUpdateDate: | 09/19/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 43923-020 | WI | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | A88441 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.