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Individual

ELDER MENDOZA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
3114 W BEVERLY BLVD, MONTEBELLO, CA 90640-2217
(323) 726-1317
(323) 726-3870
Mailing address
2149 E WARNER RD, STE 102, TEMPE, AZ 85284-3495
(480) 393-0309
(480) 610-6189

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA19362
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PA19362
CA
Enumeration date
10/01/2007
Last updated
08/22/2019
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