Organization
DAVID J. MATA, M.D., INC
Active
Other names
DAVID J MATA, M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID JOSEPH MATA M.D., (PRESIDENT)
(951) 765-1727
Entity
Organization
Contact information
Practice address
255 N GILBERT ST, BUILDING B, SUITE A, HEMET, CA 92543-4066
(951) 765-1727
(951) 929-3601
Mailing address
255 N GILBERT ST, BUILDING B, SUITE A, HEMET, CA 92543-4066
(951) 765-1727
(951) 929-3601
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
G64183
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G641830
—
CA
Enumeration date
12/10/2010
Last updated
12/10/2010
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