Healthcare Provider Details

I. General information

NPI: 1972139632
Provider Name (Legal Business Name): NATALIA MENDEZ PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2020
Last Update Date: 12/02/2024
Certification Date: 11/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BLDG 22190 92056 MARINE DR.
OCEANSIDE CA
92058
US

IV. Provider business mailing address

MARINE DRIVE BUILDING 22190
OCEANSIDE CA
92058
US

V. Phone/Fax

Practice location:
  • Phone: 760-725-3784
  • Fax:
Mailing address:
  • Phone: 513-884-3088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: