Individual provider · Type 1 NPI

Brian Jesse Mata

Driver · Los Angeles, CA

NPI number 1902504194 Active

Practice location

12021 South Wilmington Ave, Building 18 Suite 300
Los Angeles, CA 90059

Call (424) 454-6041 Map

Specialties and licenses

TaxonomyCodeLicense
Driver Primary 172A00000XNone listed

Driver: A person employed to operate a motor vehicle as a carrier of persons or property.

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About NPI 1902504194

Brian Jesse Mata's National Provider Identifier is 1902504194, issued on Feb 17, 2023. The primary taxonomy on file is Driver (172A00000X), and the practice location is in Los Angeles, CA. The record was last updated on Feb 17, 2023.