Provider Demographics
NPI:1356792394
Name:MEND MEDICAL INC
Entity type:Organization
Organization Name:MEND MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARDILLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-488-2830
Mailing Address - Street 1:4312 WOODMAN AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-5546
Mailing Address - Country:US
Mailing Address - Phone:310-488-2830
Mailing Address - Fax:888-502-9285
Practice Address - Street 1:4312 WOODMAN AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-5546
Practice Address - Country:US
Practice Address - Phone:310-488-2830
Practice Address - Fax:888-502-9285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-30
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA82516207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty