Healthcare Provider Details

I. General information

NPI: 1386478378
Provider Name (Legal Business Name): AJMATS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2024
Last Update Date: 12/14/2024
Certification Date: 12/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W HUNTINGTON DR
ARCADIA CA
91007-3402
US

IV. Provider business mailing address

PO BOX 5164
PASADENA CA
91117-0164
US

V. Phone/Fax

Practice location:
  • Phone: 626-898-8000
  • Fax:
Mailing address:
  • Phone: 818-522-3595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIEL JOSEPH YBARRA
Title or Position: PRESIDENT
Credential: MD
Phone: 818-522-3595