Provider Demographics
NPI:1427240225
Name:MENDOZA, VERONICA (MEDICAL ASSISTANT)
Entity type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:
Last Name:MENDOZA
Suffix:
Gender:F
Credentials:MEDICAL ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34800 BOB WILSON DRIVE STE #100
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92134
Mailing Address - Country:US
Mailing Address - Phone:619-532-7199
Mailing Address - Fax:619-532-6587
Practice Address - Street 1:34800 BOB WILSON DR STE 100
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92134-1100
Practice Address - Country:US
Practice Address - Phone:619-532-7199
Practice Address - Fax:619-532-6587
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital