Organization
MENDOZA OPTOMETRIC CORPORATION
Active
Organization
MENDOZA OPTOMETRIC CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMUNDO G MENDOZA OD (OWNER)
(619) 475-2184
Entity
Organization
Contact information
Practice address
2411 E PLAZA BLVD, NATIONAL CITY, CA 91950-5101
(619) 475-2184
Mailing address
2411 E PLAZA BLVD, NATIONAL CITY, CA 91950-5101
(619) 475-2184
Taxonomy
Speciality
Code
Description
License number
State
261QS0132X
Ophthalmologic Surgery Clinic/Center
Primary
OPT 8150T
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0081500
—
CA
Enumeration date
05/15/2008
Last updated
01/07/2013
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