Penny Angel Mata, MEDICAL ASSISTANT

NPI #1518601020 in Caldwell, Idaho

Provider Information

NPI Number
1518601020
Entity Type
Individual
Name
Penny Angel Mata, MEDICAL ASSISTANT
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Specialist/Technologist
Credential
MEDICAL ASSISTANT
Enumeration Date
Apr 21, 2022
Last Updated
Apr 21, 2022

Practice Location

Address
4521 THOMAS JEFFERSON ST
State
Idaho
ZIP Code
83605-5100
Phone
(208) 454-4820

Specialties & Taxonomy Codes

Specialty
Specialist/Technologist

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