Healthcare Provider Details

I. General information

NPI: 1053794941
Provider Name (Legal Business Name): JOEL MENDEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2015
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4730 MARINE AVE
LAWNDALE CA
90260-1247
US

IV. Provider business mailing address

6638 ALDEA AVE
VAN NUYS CA
91406-5405
US

V. Phone/Fax

Practice location:
  • Phone: 424-374-8434
  • Fax:
Mailing address:
  • Phone: 323-559-8187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: