Individual
DR. DANIEL MATEMOTJA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
711 EAST ROSECRANS AVENUE, COMPTON, CA 90221
(310) 635-5223
(310) 635-2846
Mailing address
711 EAST ROSECRANS AVENUE, COMPTON, CA 90221
(310) 635-5223
(310) 635-2846
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A35512
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A355121
—
CA
01
—
954825811
TAX ID
CA
01
—
GR0100760
GROUP MEDICAID
CA
Enumeration date
07/28/2006
Last updated
11/14/2007
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