Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | A152301 | CA |
NPI | 1013371400 |
---|---|
Provider Name | Matthew Mejia |
First Address | Harbor City, CA 90710-2076 |
Second Address | Harbor City, CA 90710-2076 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2016 |
Last Update Date | 19/03/2019 |