Provider Demographics
NPI:1396285607
Name:RAUL Y. MENDOZA, MD INC
Entity type:Organization
Organization Name:RAUL Y. MENDOZA, MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:WEATHERLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-834-8341
Mailing Address - Street 1:5500 MING AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-9120
Mailing Address - Country:US
Mailing Address - Phone:661-834-8341
Mailing Address - Fax:661-834-6095
Practice Address - Street 1:5500 MING AVE STE 210
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-9120
Practice Address - Country:US
Practice Address - Phone:661-834-8341
Practice Address - Fax:661-834-6095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-06
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty