Mendoza, Angel

Mendoza, Angel is an individual health care provider with primary practice located at 1650 County Services Pkwy , Marietta GA 30008-4010. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Mendoza, Angel can be contacted via phone (770) 514-2361.

Contact Information

Primary practice address
1650 County Services Pkwy Marietta GA 30008-4010
Phone: (770) 514-2361
Fax: (770) 514-2811
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 40485 Georgia

Profile Details

NPI number 1194729707
LBN Legal business name Mendoza, Angel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2005
Last updated Jul 8th, 2007 - about 19 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 1194729707 NPPES
Georgia MEDICAID 00672174A

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