Individual
JOSE DE LA MOTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-3008
(215) 707-1387
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-3008
(215) 707-1387
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD438771
PA
207V00000X
Obstetrics & Gynecology Physician
MT187989
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203BX0001X
—
PA
Enumeration date
03/23/2009
Last updated
03/21/2017
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