Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A95161 | CA |
Y | 2080A0000X | Adolescent Medicine | 13045 | NV |
NPI | 1255350922 |
---|---|
Provider Name | Claudine Aguilar Mendoza |
First Address | Phoenix, AZ 85020-4492 |
Second Address | Phoenix, AZ 85020-4492 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 21/12/2021 |