Individual
EMMANUEL MATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RD
Contact information
Practice address
924 S MARIPOSA AVE APT 2, LOS ANGELES, CA 90006-1425
(213) 239-3035
Mailing address
924 S MARIPOSA AVE APT 2, LOS ANGELES, CA 90006-1425
(213) 239-3035
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1086055
CA
Other
Enumeration date
06/18/2013
Last updated
06/18/2013
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