Healthcare Provider Details

I. General information

NPI: 1043203805
Provider Name (Legal Business Name): HILDA DE LA TORRE MENDOZA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HILDA DE LA TORRE M.D.

II. Dates (important events)

Enumeration Date: 08/26/2005
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1640 NEWPORT BLVD STE 340
COSTA MESA CA
92627-7730
US

IV. Provider business mailing address

1640 NEWPORT BLVD STE 340
COSTA MESA CA
92627-7730
US

V. Phone/Fax

Practice location:
  • Phone: 949-645-4670
  • Fax: 949-722-6866
Mailing address:
  • Phone: 949-645-4670
  • Fax: 949-722-6866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA82627
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: