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General NPI Number Information
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NPI Number | 1194798496
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Entity Type | Individual
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Provider Name | LEONARDO CESAR MENDOZA III MD
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Gender | Male
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Dates
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Enumeration Date | 02/08/2006
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 1751 W ORANGE GROVE RD STE 111
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City | TUCSON
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State | AZ
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Zip | 85704-1192
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Country | US
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Telephone | 520-593-7761
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Fax | 520-593-7764
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Provider Business Mailing Address
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Address Line | 1751 W ORANGE GROVE RD STE 111
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City | TUCSON
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State | AZ
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Zip | 85704-1192
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Country | US
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Telephone | 520-593-7761
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Fax | 520-593-7764
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204C00000X
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Taxonomy Name | Sports Medicine (Neuromusculoskeletal Medicine) Physician
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License Number | 35869
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 35867
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35869
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License Number State | AZ
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