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Individual

JOSEPH JOHN BAZA MENDIOLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
133 ROUTE 3, DEDEDO, GU 96929-6911
(671) 969-4844
Mailing address
PO BOX 5786, HAGATNA, GU 96932-8669
(671) 777-5925

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
06/06/2021
Last updated
06/06/2021
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