Individual
MARIO MENDOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1441 SWAN ST, LIVINGSTON, CA 95334-1836
(209) 259-1160
Mailing address
705 ENTERPRISE CT, ATWATER, CA 95301-9589
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A4343640
CA DMV
CA
Enumeration date
01/23/2019
Last updated
01/23/2019
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