Mata, Fernando U
Mata, Fernando U is an individual health care provider with primary practice located at 10200 Main St , Lamont CA 93241-1700. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Mata, Fernando U can be contacted via phone (661) 845-1788.Contact Information
Primary practice address
10200 Main St
Lamont CA 93241-1700
Phone: (661) 845-1788
Fax: (661) 845-1791
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA12281 | California |
Profile Details
| NPI number | 1063594117 |
|---|---|
| LBN Legal business name | Mata, Fernando U |
| Credentials | PAC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 19th, 2006 |
| Last updated | Sep 13th, 2017 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063594117 | NPPES |
| California | MEDICAID | PA12281 |
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