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General NPI Number Information
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NPI Number | 1689688343
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Entity Type | Organization
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Legal Business Name | ANTHONY L. MENDOZA, M.D., A PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 8207 ELDEN AVE
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City | WHITTIER
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State | CA
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Zip | 90605-1012
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Country | US
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Telephone | 562-632-1258
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Fax |
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Provider Business Mailing Address
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Address Line | 823 S ATLANTIC BLVD SUITE 5
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City | MONTEREY PARK
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State | CA
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Zip | 91754
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Country | US
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Telephone | 626-281-0125
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Fax | 626-281-0102
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. ANTHONY L. MENDOZA
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Credential | M.D..
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Telephone | 562-632-1258
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A73075
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License Number State | CA
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