Individual
DR. JESSE MATA DE LEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
16660 PARAMOUNT BLVD, SUITE 211, PARAMOUNT, CA 90723-5433
(562) 633-5438
(562) 633-1685
Mailing address
16660 PARAMOUNT BLVD, SUITE 211, PARAMOUNT, CA 90723-5433
(562) 633-5438
(562) 633-1685
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
A32517
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A325170
—
CA
Enumeration date
04/11/2007
Last updated
07/08/2007
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