Healthcare Provider Details

I. General information

NPI: 1467990036
Provider Name (Legal Business Name): CHRISTOPHER MENDEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2017
Last Update Date: 02/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

473 CABRILLO ST BUILDING 422
MONTEREY CA
93944-3201
US

IV. Provider business mailing address

473 CABRILLO ST BUILDING 422
MONTEREY CA
93944-3201
US

V. Phone/Fax

Practice location:
  • Phone: 831-242-5318
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: