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General NPI Number Information
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NPI Number | 1396939245
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Entity Type | Individual
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Provider Name | RUMEL MENDOZA LLANTADA D.C.
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Gender | Male
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Dates
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Enumeration Date | 09/04/2007
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Last Update Date | 04/29/2020
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Provider Practice Location Address
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Address Line | 5252 BALBOA AVE STE 701
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City | SAN DIEGO
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State | CA
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Zip | 92117-6930
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Country | US
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Telephone | 858-384-6556
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Fax | 858-225-8320
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Provider Business Mailing Address
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Address Line | 5252 BALBOA AVE STE 701
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City | SAN DIEGO
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State | CA
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Zip | 92117-6930
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Country | US
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Telephone | 858-384-6556
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Fax | 858-225-8320
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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 | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 28696
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License Number State | CA
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