JUAN ANTONIO MENDOZA NPI 1154621720

NPI Information

JUAN ANTONIO MENDOZA is an amputee clinic center in San Diego, CA. The provider is an entity, facility, or distinct part of a facility providing counseling, fitting, custom design, prescriptive, and training services related to congenital or postoperative absence of all or part of a limb or limbs. JUAN ANTONIO MENDOZA NPI is 1154621720. The provider is registered as an organization entity type.
The provider Is Doing Business As Abi P&o.

The provider's business location address is:

6190 FAIRMOUNT AVE
SUITE A
SAN DIEGO, CA
ZIP 92120-428
Phone: (619) 285-5040
Fax: (619) 285-5045

The provider's authorized official is John Prater .
The authorized official title is Office Manager and has the following contact phone number (619) 285-5040.

The enumeration date for this NPI number is 10/28/2010 and was last updated on 3/4/2011.

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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