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Organization
MENDEZ TRANSPLANT AND UROLOGICAL MEDICAL GROUP, INC.
Active
Organization
MENDEZ TRANSPLANT AND UROLOGICAL MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS PAUL BOGAARD M.D. (OWNER/PRESIDENT)
(213) 802-0100
Entity
Organization
Contact information
Practice address
1401 S GRAND AVE, LOS ANGELES, CA 90015-3010
(213) 802-0100
(626) 795-3229
Mailing address
PO BOX 1004, SIERRA MADRE, CA 91025-4004
(213) 802-0100
(626) 795-3229
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LAB26009F
—
CA
05
—
W876
—
CA
05
—
ZZZ70112Z
—
CA
Enumeration date
10/05/2006
Last updated
05/22/2019
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