Provider Demographics
NPI:1720472327
Name:MENDEZ, FERNANDO (MD)
Entity type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:
Last Name:MENDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7312 W CHEYENNE AVE STE 8
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-7425
Mailing Address - Country:US
Mailing Address - Phone:702-728-1328
Mailing Address - Fax:725-205-1977
Practice Address - Street 1:7312 W CHEYENNE AVE STE 8
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-7425
Practice Address - Country:US
Practice Address - Phone:725-308-8465
Practice Address - Fax:725-205-1977
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-23
Last Update Date:2024-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV200192084P0800X, 2084P0804X
CAA1709562084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry