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Organization
DANIEL MATEMOTJA, MD INC
Active
Organization
DANIEL MATEMOTJA, MD INC
Active
Other names
May Family Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL MATEMOTJA MD (OWNER)
(310) 635-5223
Entity
Organization
Contact information
Practice address
711 E ROSECRANS AVE, EAST RANCHO DOMINGUEZ, CA 90221-2143
(310) 635-5223
(310) 635-8246
Mailing address
711 E ROSECRANS AVE, EAST RANCHO DOMINGUEZ, CA 90221-2143
(310) 635-5223
(310) 635-8246
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A35512
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A35512
MEDICAL LICENSE DIRECTOR
CA
05
—
GR0100760
—
CA
Enumeration date
10/03/2007
Last updated
12/05/2007
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