Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Michael Edward Mathis, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1053013870

Michael Edward Mathis, MD is a Student in an Organized Health Care Education/Training Program in Riverside, California. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4510 Brockton Ave
Riverside, CA 92501-4015
Phone: (951) 897-9896
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1053013870
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 17, 2023
Last updated in NPPESMarch 17, 2023
Certification dateMarch 17, 2023
Mailing address4510 Brockton Ave, Riverside, CA 92501-4015

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