Individual
TYLER NICHOLAS MENDOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RT
Contact information
Practice address
11262 SEGA LN, FONTANA, CA 92337-6820
(714) 477-3964
Mailing address
11262 SEGA LN, FONTANA, CA 92337-6820
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
38508
CA
Other
Enumeration date
10/13/2016
Last updated
10/13/2016
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