Individual
DR. OMAR MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1171 W TARGET RANGE RD, NOGALES, AZ 85621-2415
(520) 285-8020
Mailing address
4636 CAPLES CIR, EL PASO, TX 79903-1511
(915) 881-4961
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
204682
CA
207P00000X
Emergency Medicine Physician
Primary
33157
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33157
—
AZ
Enumeration date
07/26/2005
Last updated
10/01/2025
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