Healthcare Provider Details

I. General information

NPI: 1922902329
Provider Name (Legal Business Name): MYNOR E MENDEZ AGUILAR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 E ARROW HWY
POMONA CA
91767-2535
US

IV. Provider business mailing address

970 MENLO AVE APT 18
LOS ANGELES CA
90006-2821
US

V. Phone/Fax

Practice location:
  • Phone: 909-398-4383
  • Fax:
Mailing address:
  • Phone: 213-548-8741
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: