Organization
DARK SIDE MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTOR ESTRADA MENDOZA M.D. (OWNER AND TREATING PHYSICIAN)
(256) 997-6182
Entity
Organization
Contact information
Practice address
5130 CYRUS CIR, BIRMINGHAM, AL 35242-4630
(205) 981-0414
(888) 330-6501
Mailing address
5130 CYRUS CIR, BIRMINGHAM, AL 35242-4630
(205) 981-0414
(888) 380-6501
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
25607
AL
Other
Enumeration date
11/14/2011
Last updated
11/14/2011
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