Organization
PIONEERS MEMORIAL HEALTHCARE DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD MENDOZA (CEO)
(760) 351-3333
Entity
Organization
Contact information
Practice address
731 CESAR CHAVEZ BLVD, CALEXICO, CA 92231-2105
(760) 357-4850
(760) 357-6991
Mailing address
731 CESAR CHAVEZ BLVD, CALEXICO, CA 92231-2105
(760) 357-4850
(760) 357-6991
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
255734
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN255734
RN LICENCE
CA
01
—
RNP9528
RN FURNISHING #
CA
Enumeration date
02/28/2007
Last updated
08/22/2020
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