ELDER MENDOZA (NPI# 1568659936) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568659936 |
| Entity Type | Individual |
| Full Name | ELDER MENDOZA |
| Credential | PA-C |
| Practice Address |
3114 W Beverly Blvd Montebello CA 90640-2217 |
| Mailing Address |
2149 E Warner Rd Ste 102 Tempe AZ 85284-3495 |
| Practice Telephone | 3237261317 |
| Practice Fax Number | 3237263870 |
| Mailing Telephone | 4803930309 |
| Mailing Fax Number | 4806106189 |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2019-08-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA19362 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | PA19362 | 05 |
| Street Address |
3114 W BEVERLY BLVD |
| City | MONTEBELLO |
| State | CA |
| Zip Code | 90640-2217 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114910908 | Shamik Bhadra | Specialist | 3114 W Beverly Blvd, Montebello, CA 90640 | 2005-08-26 |
| 1538780218 | Lain L Lee | Nurse Practitioner | 3114 W Beverly Blvd, Montebello, CA 90640-2217 | 2020-05-04 |
| 1477931186 | Elisa Park | Internal Medicine | 3114 W Beverly Blvd, Montebello, CA 90640-2217 | 2015-05-13 |
| 1811338270 | Internal Medicine Mds Corp | Internal Medicine | 3114 W Beverly Blvd, Montebello, CA 90640-2217 | 2013-07-15 |
| 1053657684 | Maybel Min Tan | Internal Medicine | 3114 W Beverly Blvd, Montebello, CA 90640-2217 | 2012-12-31 |
| 1497048672 | Lathika Raakesh | Internal Medicine | 3114 W Beverly Blvd, Montebello, CA 90640 | 2011-05-23 |
| 1912223850 | Kay Khine Kyaw | Specialist | 3114 W Beverly Blvd, Montebello, CA 90640 | 2010-04-16 |
| 1538200860 | Soma Barua | Family Medicine | 3114 W Beverly Blvd, Montebello, CA 90640-2217 | 2007-02-09 |
| 1295894871 | Shahe Pashayan | Internal Medicine | 3114 W Beverly Blvd, Montebello, CA 90640-2217 | 2006-12-08 |
| 1083649651 | L.a. County Nephrology Associates A Medical Corporation | Specialist | 3114 W Beverly Blvd, Montebello, CA 90640-2217 | 2006-07-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184242901 | Marie-christine Wiltord | Marriage & Family Therapist | 1447 W. Beverly Blvd., Montebello, CA 90640 | 2020-07-08 |
| 1366093668 | Ana Lesly Tavira-nava | Student in an Organized Health Care Education/Training Program | 3316 W. Beverly Blvd., Montebello, CA 90640 | 2019-09-27 |
| 1952803256 | America Alaniz | Marriage & Family Therapist | 3524 1/4 W. Beverly Blvd., Montebello, CA 90640 | 2018-03-02 |
| 1669987913 | Tender Loving Hospice Care, Inc. | Hospice Care, Community Based | 3528 W Beverly Blvd, Suite D, Montebello, CA 90640 | 2017-12-08 |
| 1518472869 | Healing Angels Nursing Services, Inc. | Home Health | 3538 W Beverly Blvd, Suite C, Montebello, CA 90640 | 2017-12-08 |
| 1427579143 | Paul Gonzales | Specialist/Technologist | 1525 Via Palermo, Montebello, CA 90640 | 2017-07-03 |
| 1942720859 | Rachel Lu | Pharmacist | 800 W. Whittier Blvd., Montebello, CA 90640 | 2017-06-21 |
| 1194254508 | Jill Tanigawa | Pharmacist | 2525 W Via Campo, Montebello, CA 90640 | 2017-06-08 |
| 1619406121 | Nutrition Care Consulting | Dietitian, Registered | 2605 Beverly Blvd, Montebello, CA 90640 | 2017-06-08 |
| 1992165815 | Hope Artificial Limb & Brace,llc | Prosthetic/Orthotic Supplier | 2609 W. Beverly Blvd #3, Montebello, CA 90640 | 2016-03-04 |
| Find all providers in zip 90640 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558515742 | Justin Uchida | Physician Assistant | 815 W. Washington Blvd., Montebello, CA 90640-6123 | 2008-11-14 |
| 1275751752 | Junko Masutani | Physician Assistant | 3112 West Beverly Blvd., Montebello, CA 90640-1537 | 2007-04-23 |
| 1699702662 | Charles B. Worley | Physician Assistant | 3106 West Beverly Blvd, Montebello, CA 90640 | 2006-06-27 |
| 1518371525 | Ngin Lam Ong | Physician Assistant | 2603 Via Campo, Montebello, CA 90640-1807 | 2014-06-17 |
| 1518261981 | Esther Wonson Ha | Physician Assistant | 101 E Beverly Blvd, Suite 200, Montebello, CA 90640-4300 | 2010-12-28 |
| 1710129077 | Keerty Zoe Sharma | Physician Assistant | 101 E Beverly Blvd, Suite 100, Montebello, CA 90640-4300 | 2009-04-01 |
| 1619070174 | Mario Vargas | Physician Assistant | 2603 Via Campo, Montebello, CA 90640 | 2006-09-07 |
| 1902833460 | Veronica Viramontes | Physician Assistant | 3114 W Beverly Blvd, Montebello, CA 90640-2217 | 2006-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760089437 | Karine Harutyunyan | Physician Assistant | 500 E Colorado St Ste 101, Glendale, CA 91205-1607 | 2020-10-06 |
| 1437756228 | Kale Burket | Physician Assistant | Bldg 523, S 8th St, El Centro, CA 92243 | 2020-10-05 |
| 1548867666 | Heba Marzouk Al-shoubaki | Physician Assistant | 633 S Pepper St, Anaheim, CA 92802-1459 | 2020-10-01 |
| 1275140550 | Lisa Lynn Passalacqua | Physician Assistant | 431 7th St, Norco, CA 92860-1671 | 2020-09-30 |
| 1144833989 | Trisha Taylor | Physician Assistant | 10399 Tivoli Way, Yucaipa, CA 92399-6017 | 2020-08-30 |
| 1457963944 | Harlan William Monahan | Physician Assistant | 5210 Del Rio Rd, Sacramento, CA 95822-2519 | 2020-08-18 |
| 1275144313 | Sofia Carmen Bustillo | Physician Assistant | 1709 Coral Pl, Seal Beach, CA 90740-5712 | 2020-08-12 |
| 1124638663 | Gayaneh Gharakhani | Physician Assistant | 1323 E Broadway Apt 110, Glendale, CA 91205-4018 | 2020-08-07 |
| 1144830183 | Loc Bao Tran | Physician Assistant | 8937 Emerson Pl, Rosemead, CA 91770-2813 | 2020-08-04 |
| 1558997957 | Sarah Lubinsky | Physician Assistant | 1511 Montana Ave, Santa Monica, CA 90403-1891 | 2020-03-17 |
| Find all providers with the same taxonomy | ||||
| City | MONTEBELLO |
| Zip Code | 90640 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.