Individual
MR. ENRIQUE MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2204 S EL CAMINO REAL, SUITE 102, OCEANSIDE, CA 92054-6306
(760) 477-3150
(760) 754-6785
Mailing address
3905 WARING RD, OCEANSIDE, CA 92056-4405
(760) 724-9000
(760) 724-3686
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
35503
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35503
CALIFORNIA LICENSE NUMBER
CA
01
—
CI933Z
MEDICARE PTAN
CA
Enumeration date
04/23/2009
Last updated
12/03/2009
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