Individual
CLYDE C MENDONCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2141 E WARNER RD, SUITE 101, TEMPE, AZ 85284-3493
(480) 969-8714
(480) 464-0189
Mailing address
2149 E WARNER RD, SUITE 101, TEMPE, AZ 85284-3494
(480) 610-6100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
229265
MA
207RN0300X
Nephrology Physician
Primary
40391
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
347927
—
AZ
Enumeration date
07/07/2006
Last updated
06/19/2012
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