Individual
RAYMOND MENDOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1457 HEMLOCK AVE APT B, IMPERIAL BEACH, CA 91932-3852
(209) 292-3652
Mailing address
1457 HEMLOCK AVE APT B, IMPERIAL BEACH, CA 91932-3852
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
CA
Other
Enumeration date
09/24/2024
Last updated
09/24/2024
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