Joseph John Baza Mendiola

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Dededo, GU

NPI 1013584333 · NPPES record last updated Jun 6, 2021

Key facts

NPI
1013584333
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
133 Route 3
Dededo, GU 96929-6911
Phone
(671) 969-4844
NPI assigned
Jun 6, 2021
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

133 Route 3
Dededo, GU 96929-6911

Mailing address

PO Box 5786
Hagatna, GU 96932-8669
Phone (671) 777-5925

Other providers in Dededo, GU

All providers in Dededo, GU · Student in an Organized Health Care Education/Training Program in Guam

Sources for this page

Verify at the official NPI Registry.