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Individual

ERIC LIONEL MENDOZA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
15243 VANOWEN ST, SUITE 107, VAN NUYS, CA 91405-3605
(818) 849-6613
Mailing address
11611 BLUCHER AVE, UNIT #173, GRANADA HILLS, CA 91344-3249
(818) 741-8326

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
10946
CA

Other

Enumeration date
08/27/2015
Last updated
08/27/2015
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