MS. AMADA BAUTISTA MENDOZA CNP NPI 1013059062

NPI Information

MS. Amada Bautista Mendoza, CNP is a women's health nurse practitioner in Bellflower, CA. MS. Amada Bautista Mendoza, CNP NPI is 1013059062. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

16323 CLARK AVE
BELLFLOWER, CA
ZIP 90706-209
Phone: (562) 925-7716
Fax: (562) 867-0665

The NPI 1013059062 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The CLIA number assigned to this NPI record is 05D2081478 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/13/2007 and was last updated on 7/8/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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