Individual
REBECA J MENDOZA GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1401 WILLIAM ST SE, ALBUQUERQUE, NM 87102-4661
(505) 768-5450
Mailing address
1620 N MAIN ST, SPANISH FORK, UT 84660-1008
(801) 822-2234
(505) 281-5320
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2018-0083
NM
Other
Enumeration date
10/18/2018
Last updated
07/15/2024
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