Doctor Name: | DR. EMMA M MATEL |
NPI Number: | 1285763730 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | A23609 |
Business Practice Address: | 4060 Fairmount Ave San Diego, CA - 921051608 |
Business Phone Number: | 6192804213 |
Business Fax Number: | 6192803545 |
Mailing Address: | 4060 Fairmount Ave, SAN DIEGO |
State: | CA |
Postal Code: | 921051608 |
Phone Number: | 6192804213 |
Fax Number: | 6192803545 |
NPI Enumeration Date: | 03/02/2007 |
NPI Last Update Date: | 01/05/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A23609 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |