Healthcare Provider Details

I. General information

NPI: 1578536447
Provider Name (Legal Business Name): CHRISTOPHER MENDIAS PHD, ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3330 N 2ND ST STE 401
PHOENIX AZ
85012-2371
US

IV. Provider business mailing address

PO BOX 2253
PHOENIX AZ
85002-2253
US

V. Phone/Fax

Practice location:
  • Phone: 602-606-8949
  • Fax:
Mailing address:
  • Phone: 602-606-8949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberATR-009261
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code1744R1102X
TaxonomyResearch Study Specialist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: