# MR. JATIN R MATTA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1316232135
- **Gender:** Man
- **Credential:** PA-C, MPAS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | C0002229 | MD | Yes |
| 363A00000X | Physician Assistant | PA30146 | DC | — |

## Other

- **Enumeration date:** 06/09/2011
- **Last updated:** 06/09/2011