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NPI Code Detail

MEDICARE: LEONARDO C MENDOZA MD. INC

MEDICARE: LEONARDO C MENDOZA MD. INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician35032912OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1861674392
Entity Type Code : Organization
Provider Name (Legal Business Name) : LEONARDO C MENDOZA MD. INC
Provider Business Mailing Address
First Line : 3310 RIVER RD
Second Line :
City : TOLEDO
State : OH
Zip : 43614-4219
Country : US
Telephone Number : 419-389-5909
Fax Number :
Provider Business Practice Location Address
First Line : 4352 W SYLVANIA AVE
Second Line : SUITE L
City : TOLEDO
State : OH
Zip : 43623-3463
Country : US
Telephone Number : 419-843-2776
Fax Number : 419-841-2698
Authorized Official
Title or Position : OWNER/PHYSICIAN
Name : LEONARDO CESAR MENDOZA
Credential : MD
Telephone Number : 419-843-2776
Provider Enumeration Date : 11/27/2007
Last Update Date : 12/17/2007

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