Provider Demographics
NPI:1619965894
Name:MENDOZA, CARLOS A (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:A
Last Name:MENDOZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8859 FOX DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80260-6899
Mailing Address - Country:US
Mailing Address - Phone:303-867-2460
Mailing Address - Fax:303-867-2464
Practice Address - Street 1:9141 GRANT ST
Practice Address - Street 2:SUITE 200
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4374
Practice Address - Country:US
Practice Address - Phone:303-427-1503
Practice Address - Fax:303-412-1745
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2008-06-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO26154207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01261544Medicaid
CO841198813OtherMOUNTAIN VIEW INTERPRETATION
CO841198813OtherMOUNTAIN VIEW INTERPRETATION
CO91044Medicare PIN