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NPI Code Detail

MEDICARE: DR. RENATO MENDOZA SANDOVAL M.D.

MEDICARE: DR. RENATO MENDOZA SANDOVAL M.D.
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
1207RE0101XEndocrinology, Diabetes & Metabolism Physician2009017905MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932145448
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RENATO MENDOZA SANDOVAL M.D.
Provider Business Mailing Address
First Line : 600 NE ADAMS DAIRY PKWY
Second Line :
City : BLUE SPRINGS
State : MO
Zip : 64014-5493
Country : US
Telephone Number : 816-347-5200
Fax Number : 816-347-5206
Provider Business Practice Location Address
First Line : 600 NE ADAMS DAIRY PKWY
Second Line :
City : BLUE SPRINGS
State : MO
Zip : 64014-5493
Country : US
Telephone Number : 816-347-5200
Fax Number : 816-347-5206
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2006
Last Update Date : 07/16/2024

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