Provider Demographics
NPI:1609031392
Name:MENDEZ MEDICAL PRODUCTS
Entity Type:Organization
Organization Name:MENDEZ MEDICAL PRODUCTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALVIN
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:MENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-590-9337
Mailing Address - Street 1:12375 MILLS AVE
Mailing Address - Street 2:BLDG. 7
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-2082
Mailing Address - Country:US
Mailing Address - Phone:909-590-9337
Mailing Address - Fax:909-590-8377
Practice Address - Street 1:12375 MILLS AVE
Practice Address - Street 2:BLDG. 7
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-2082
Practice Address - Country:US
Practice Address - Phone:909-590-9337
Practice Address - Fax:909-590-8377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4327030001Medicare NSC