Individual
PAUL P MENDIOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
1951 W 25TH ST, SUITE C, YUMA, AZ 85364-6925
(928) 726-7900
(928) 726-7901
Mailing address
PO BOX 6956, YUMA, AZ 85366-6956
(928) 343-7911
(928) 343-9528
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3057
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
803909
—
AZ
Enumeration date
07/31/2006
Last updated
12/19/2007
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