# DANIEL MATEMOTJA MD INC

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

## Provider details

- **NPI number:** 1467622076
- **Authorized official:** DR. DANIEL MATEMOTJA MD (OWNER/MEDICAL DOCTOR)
- **Authorized official phone:** (310) 637-0318

## Contact information

- **Practice address:** 3737 MARTIN LUTHER KING JR BLVD, SUITE 106, LYNWOOD, CA 90262-3513
- **Practice address phone:** (310) 637-0318
- **Practice address fax:** (310) 637-6722
- **Mailing address:** 3737 MARTIN LUTHER KING JR BLVD, SUITE 106, LYNWOOD, CA 90262-3513
- **Mailing address phone:** (310) 637-0318
- **Mailing address fax:** (310) 637-6722

## Taxonomy

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

## Other

- **Enumeration date:** 03/11/2008
- **Last updated:** 03/11/2008