Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | DR.0060213 | CO |
NPI | 1194188359 |
---|---|
Provider Name | David Mendez |
First Address | Aurora, CO 80045-2570 |
Second Address | Aurora, CO 80045-2518 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2016 |
Last Update Date | 23/07/2020 |