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General NPI Number Information
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NPI Number | 1215109954
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Entity Type | Organization
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Legal Business Name | MENDEZ MEDICAL CENTER INC
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Dates
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Enumeration Date | 04/01/2008
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Last Update Date | 04/20/2021
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Provider Practice Location Address
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Address Line | 4282 GENESEE AVE SUITE 201
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City | SAN DIEGO
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State | CA
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Zip | 92117
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Country | US
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Telephone | 661-330-8753
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Fax | 858-246-6374
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Provider Business Mailing Address
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Address Line | 4282 GENESEE AVE SUITE 201
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City | SAN DIEGO
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State | CA
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Zip | 92117-4946
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Country | US
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Telephone | 858-268-0300
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Fax | 877-409-7359
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. DIEGO MENDEZ
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Credential | MD
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Telephone | 858-268-0300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A47906
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A47906
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | A47906
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License Number State | CA
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