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General NPI Number Information
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NPI Number | 1942761341
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Entity Type | Individual
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Provider Name | DORIAN BLUE MENDOZA MD
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Gender | Male
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Dates
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Enumeration Date | 03/27/2019
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 9675 BRIGHTON WAY STE 422
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-5139
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Country | US
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Telephone | 310-273-0040
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Fax |
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Provider Business Mailing Address
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Address Line | 5767 W CENTURY BLVD SUITE 400
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City | LOS ANGELES
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State | CA
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Zip | 90095-5631
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Country | US
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Telephone | 310-301-8707
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | A178555
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License Number State | CA
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