Individual
DR. FORTUNATA L. MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1111 GRAND AVE, STE. K, DIAMOND BAR, CA 91765-4171
(909) 860-4254
(909) 860-2674
Mailing address
1111 GRAND AVE, STE. K, DIAMOND BAR, CA 91765-4171
(909) 860-4254
(909) 860-2674
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
C41510
CA
Other
Enumeration date
06/27/2006
Last updated
07/08/2007
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