Healthcare Provider Details
I. General information
NPI: 1760814891
Provider Name (Legal Business Name): BERNARDO CURI MENDES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/31/2013
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
200 UCLA MEDICAL PLZ STE 526
LOS ANGELES CA
90095-0001
US
IV. Provider business mailing address
5767 W CENTURY BLVD STE 400
LOS ANGELES CA
90045-5631
US
V. Phone/Fax
- Phone: 310-206-6294
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0129X |
| Taxonomy | Vascular Surgery Physician |
| License Number | 59362 |
| License Number State | MN |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0129X |
| Taxonomy | Vascular Surgery Physician |
| License Number | C202070 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: