Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Brian Jesse Mata

Individual provider Driver · NPI 1902504194

Brian Jesse Mata is a Driver in Los Angeles, California. Registered with an NPI since 2023.

In the registry since
2023

Practice location Address checks out

12021 S Wilmington Ave Bldg 18 Ste 300
Los Angeles, CA 90059
Phone: (424) 454-6041
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Driver (primary) Taxonomy 172A00000X

Record details

NPI number1902504194
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 17, 2023
Last updated in NPPESFebruary 17, 2023
Certification dateFebruary 17, 2023
Mailing address12021 South Wilmington Ave, Building 18 Suite 300, Los Angeles, CA 90059

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