Individual
JOSEF LUSUNG MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2101 COURAGE DR, FAIRFIELD, CA 94533-6717
(707) 428-1131
Mailing address
2101 COURAGE DR, FAIRFIELD, CA 94533-6717
(707) 428-1131
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
737145
CA
Other
Enumeration date
12/07/2023
Last updated
12/07/2023
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