Individual
MR. OSBERTO MOISES PABLO MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSS
Contact information
Practice address
1345 BIRCH AVE, COTTAGE GROVE, OR 97424-1416
(415) 942-3939
Mailing address
1345 BIRCH AVE, COTTAGE GROVE, OR 97424-1416
(415) 942-3939
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
THW000111818
OR
Other
Enumeration date
08/05/2024
Last updated
08/05/2024
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