Provider Demographics
NPI:1023273307
Name:MENDOZA, JESUS H (CPO)
Entity type:Individual
Prefix:MR
First Name:JESUS
Middle Name:H
Last Name:MENDOZA
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7720 CARDINAL CT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-3333
Mailing Address - Country:US
Mailing Address - Phone:858-292-7449
Mailing Address - Fax:858-292-5496
Practice Address - Street 1:8008 FROST ST
Practice Address - Street 2:SUITE 407
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4205
Practice Address - Country:US
Practice Address - Phone:858-560-0660
Practice Address - Fax:858-560-0870
Is Sole Proprietor?:No
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist