Healthcare Provider Details

I. General information

NPI: 1417878950
Provider Name (Legal Business Name): ALEJANDRO MENDOZA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18THD MEDICAL GROUP
APO AP
96367
US

IV. Provider business mailing address

PSC 80 BOX 20083
APO AP
96367-0085
US

V. Phone/Fax

Practice location:
  • Phone: 315-630-3044
  • Fax:
Mailing address:
  • Phone: 530-306-2040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number8354-5423-7070
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: