Basic Information
| Provider Information | |||||||||
| NPI: | 1225553787 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MENDOZA | ||||||||
| FirstName: | JONAZ | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 N STATE ST | ||||||||
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| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900331029 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3234091000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1200 N STATE ST | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900331029 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3234091000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/07/2017 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2279C0205X | 37229 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Critical Care |
No ID Information.