Mendoza, Evelyn

Mendoza, Evelyn is an individual health care provider with primary practice located at 301 N San Jacinto St , Hemet CA 92543-3113. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Mendoza, Evelyn can be contacted via phone (951) 766-6460.

Contact Information

Primary practice address
301 N San Jacinto St Hemet CA 92543-3113
Phone: (951) 766-6460
Fax: (951) 766-6459
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X A48611 California

Profile Details

NPI number 1558368605
LBN Legal business name Mendoza, Evelyn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2005
Last updated Feb 5th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558368605 NPPES
California Other 05D1062719 CLIA NUMBER
California Other 5945420003 CLIA NUMBER
California Other 5945420004 CLIA NUMBER
California Other 1225222029 CLIA NUMBER
California MEDICAID 00A486110 CLIA NUMBER
California Other 1457545840 CLIA NUMBER
California Other 1558555938 CLIA NUMBER
California Other 330643850 CLIA NUMBER
California Other 5945420001 CLIA NUMBER
California Other 1962696344 CLIA NUMBER
California Other 5945420002 CLIA NUMBER

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