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General NPI Number Information
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NPI Number | 1669403150
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Entity Type | Individual
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Provider Name | ROBERTO ARTURO MENDOZA P.A.
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Gender | Male
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 11/18/2021
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Provider Practice Location Address
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Address Line | 9449 IMPERIAL HWY
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City | DOWNEY
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State | CA
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Zip | 90242-2814
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Country | US
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Telephone | 562-657-2652
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Fax | 562-657-2846
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Provider Business Mailing Address
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Address Line | 20 W LOMA ALTA DR
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City | ALTADENA
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State | CA
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Zip | 91001-3931
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Country | US
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Telephone | 626-797-1689
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA15542
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License Number State | CA
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