Individual
FERNANDO MATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1137 2ND ST, STE 212, SANTA MONICA, CA 90403-5011
(310) 458-0907
(310) 458-7258
Mailing address
1137 2ND ST, STE 212, SANTA MONICA, CA 90403-5080
(310) 458-0907
(310) 458-7258
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
13604
CA
Other
Enumeration date
11/08/2006
Last updated
06/30/2009
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