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General NPI Number Information
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NPI Number | 1922289495
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Entity Type | Organization
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Legal Business Name | MENENDEZ INTEGRAL PEDIATRICS, INC.
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Dates
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Enumeration Date | 11/26/2007
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Last Update Date | 09/03/2009
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Provider Practice Location Address
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Address Line | 1510 S CENTRAL AVE SUITE 350
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City | GLENDALE
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State | CA
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Zip | 91204-2500
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Country | US
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Telephone | 818-552-2100
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Fax | 818-552-2101
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Provider Business Mailing Address
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Address Line | 1510 S CENTRAL AVE SUITE 350
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City | GLENDALE
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State | CA
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Zip | 91204-2500
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Country | US
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Telephone | 818-552-2100
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Fax | 818-552-2101
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. RICHARD MENENDEZ
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Credential | MD
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Telephone | 818-552-2100
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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 | A76738
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License Number State | CA
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