Individual
ENRIQUE MENDOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
7590 FRAZER DR, RIVERSIDE, CA 92509-5332
(951) 727-0675
(951) 727-0675
Mailing address
7590 FRAZER DR, RIVERSIDE, CA 92509-5332
(951) 727-0675
(951) 205-8601
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN217872
CA
Other
Enumeration date
11/08/2007
Last updated
04/13/2009
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