Healthcare Provider Details

I. General information

NPI: 1972569648
Provider Name (Legal Business Name): SANDRA MENDEZ, MD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2006
Last Update Date: 02/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7501 HOSPITAL DR SUITE 204
SACRAMENTO CA
95823-5405
US

IV. Provider business mailing address

7501 HOSPITAL DR SUITE 204
SACRAMENTO CA
95823-5405
US

V. Phone/Fax

Practice location:
  • Phone: 916-681-2660
  • Fax: 916-681-2671
Mailing address:
  • Phone: 916-681-2660
  • Fax: 916-681-2671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberG61146
License Number StateCA

VIII. Authorized Official

Name: SANDRA MENDEZ
Title or Position: PRESIDENT/OWNER/PROVIDER
Credential: M.D.
Phone: 916-681-2660