Provider Demographics
NPI:1336516103
Name:MENDES, ALAN JOSEPH (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:JOSEPH
Last Name:MENDES
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1489 W LACEY BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-5957
Mailing Address - Country:US
Mailing Address - Phone:559-585-8087
Mailing Address - Fax:559-585-1933
Practice Address - Street 1:201 S MADERA AVE STE 100
Practice Address - Street 2:
Practice Address - City:KERMAN
Practice Address - State:CA
Practice Address - Zip Code:93630-1129
Practice Address - Country:US
Practice Address - Phone:559-846-6336
Practice Address - Fax:559-846-3344
Is Sole Proprietor?:No
Enumeration Date:2015-08-28
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42935225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist