Individual
MR. JUAN ANTONIO MENDOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
6190 FAIRMOUNT AVE, SUITE A, SAN DIEGO, CA 92120-3428
(619) 285-5040
(619) 285-5045
Mailing address
6190 FAIRMOUNT AVE, SUITE A, SAN DIEGO, CA 92120-3428
(619) 285-5040
(619) 285-5045
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
—
—
224P00000X
Prosthetist
Primary
—
—
225000000X
Orthotic Fitter
—
—
Other
Enumeration date
10/26/2010
Last updated
10/26/2010
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