Individual
DR. JUAN MENDOZA BAUTISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6236 E PIMA ST STE 100, TUCSON, AZ 85712
(520) 327-6874
(520) 327-0028
Mailing address
5055 E BROADWAY BLVD STE A100, TUCSON, AZ 85711-3629
(205) 327-0460
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
49681
AZ
207Q00000X
Family Medicine Physician
MT199475
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
985417
—
AZ
Enumeration date
08/02/2011
Last updated
10/14/2019
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