# DANIEL MATEMOTJA MD INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063682979
- **Authorized official:** DR. DANIEL MATEMOTJA MD (OWNER/MEDICAL DOCTOR)
- **Authorized official phone:** (562) 809-0299

## Contact information

- **Practice address:** 12131 CARSON ST, HAWAIIAN GARDENS, CA 90716-1154
- **Practice address phone:** (562) 809-0299
- **Practice address fax:** (562) 809-2510
- **Mailing address:** 12131 CARSON ST, HAWAIIAN GARDENS, CA 90716-1154
- **Mailing address phone:** (562) 809-0299
- **Mailing address fax:** (562) 809-2510

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | A35512 | CA | Yes |

## Other

- **Enumeration date:** 03/06/2008
- **Last updated:** 03/06/2008