NPIMap

Organization Active NPI

Joel E. Mata, M.D. Inc.

  • Pain Medicine (Anesthesiology) Physician
  • San Diego, CA
National Provider Identifier
1336845148
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
JOEL E. MATA, M.D. INC.
Practice address
106 Thorn St
San Diego, CA 92103-5629
Phone
(619) 450-6532
NPI assigned
Feb 2, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Joel E Mata, MDNPI 1669509873
Title
Owner/ Practitioner
Phone
(858) 837-4477

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X Primary

Addresses

Primary practice location

106 Thorn St
San Diego, CA 92103-5629

Mailing address

106 Thorn St
San Diego, CA 92103-5629
Phone (619) 450-6532

Other names 1

  • Functional Restoration San Diego Doing business as

National Provider Directory

National Provider Directory

Locations

106 Thorn St
San Diego, CA 92103
Phone (619) 615-0842

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1675296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675296000000",
    "number": "1336845148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 THORN ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921035629",
            "telephone_number": "619-450-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 THORN ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921035629",
            "telephone_number": "619-450-6532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOEL E. MATA, M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-02",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A",
        "authorized_official_last_name": "MATA",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER/ PRACTITIONER",
        "authorized_official_telephone_number": "858-837-4477",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Functional Restoration San Diego",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.