Provider Demographics
NPI:1184144016
Name:ASTRID MENDOZA D O INC
Entity type:Organization
Organization Name:ASTRID MENDOZA D O INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ASTRID
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDOZA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:310-545-2532
Mailing Address - Street 1:4201 TORRANCE BLVD STE 780
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-4511
Mailing Address - Country:US
Mailing Address - Phone:310-543-2532
Mailing Address - Fax:310-540-9707
Practice Address - Street 1:4201 TORRANCE BLVD STE 780
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4511
Practice Address - Country:US
Practice Address - Phone:310-543-2532
Practice Address - Fax:310-540-9707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-21
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty