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NPI Code Detail

MEDICARE: CHRISTOPHER ISIDRO MENDOZA

MEDICARE: CHRISTOPHER ISIDRO MENDOZA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program208D00000XNV

General Provider Information

NPI Number : 1366386419
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER ISIDRO MENDOZA
Provider Business Mailing Address
First Line : 6655 S CIMARRON RD STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-2181
Country : US
Telephone Number : 702-853-3561
Fax Number :
Provider Business Practice Location Address
First Line : 6655 S CIMARRON RD STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-2181
Country : US
Telephone Number : 702-853-3561
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2026
Last Update Date : 04/17/2026

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Directions to “ CHRISTOPHER ISIDRO MENDOZA ” Practice Location

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