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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