Provider Demographics
NPI:1972064871
Name:MENDEZ LORETO, JULIO CESAR (NP)
Entity type:Individual
Prefix:MR
First Name:JULIO
Middle Name:CESAR
Last Name:MENDEZ LORETO
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 W 6TH ST APT 418
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90014-1918
Mailing Address - Country:US
Mailing Address - Phone:626-400-9483
Mailing Address - Fax:
Practice Address - Street 1:500 N CENTRAL AVE STE 800
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-3345
Practice Address - Country:US
Practice Address - Phone:818-242-4191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95010141363LA2100X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care