Individual
DR. MARCO MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
973 MICA DR, SUITE 201, CARSON CITY, NV 89705-7255
(775) 783-6190
Mailing address
973 MICA DR, SUITE 201, CARSON CITY, NV 89705-7255
(775) 783-6190
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
125059818
IL
207X00000X
Orthopaedic Surgery Physician
Primary
17066
NV
207X00000X
Orthopaedic Surgery Physician
2016-00148
NC
207X00000X
Orthopaedic Surgery Physician
A149150
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255627964
—
NC
05
—
NC2672
—
SC
Enumeration date
06/21/2011
Last updated
08/11/2021
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