Victor Manuel Mendoza-Fernandez

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

C50178 Issued in CA

Practice address

12517 Lakeshore Dr
Lakeside, CA 92040-3103

Phone

(619) 443-3843

Fax

(619) 390-1810

NPI assigned

Sep 25, 2006

Last updated

Mar 3, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Larry J Marshall MD a Professional Corporation

  • General Practice Physician
  • Lakeside, CA
  • NPI 1689884942
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393804800000",
    "number": "1134220239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12517 LAKESHORE DR",
            "city": "LAKESIDE",
            "state": "CA",
            "postal_code": "920403103",
            "telephone_number": "619-443-3843",
            "fax_number": "619-390-1810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12517 LAKESHORE DR",
            "city": "LAKESIDE",
            "state": "CA",
            "postal_code": "920403103",
            "telephone_number": "619-443-3843",
            "fax_number": "619-390-1810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA-FERNANDEZ",
        "first_name": "VICTOR",
        "middle_name": "MANUEL",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2014-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C50178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Mannino, M.D
• Larry J Marshall, MD
• Molly Marie Martin, LMFT
• Daryl Ann Marzan, DPT
• Nathan McFarland, M.D
• Patricia Ann Miller, MSN, RN
• Teresa Rochelle Mitchell
• Kammi Montanero
• Gita Dorothy Morena, PHD, LMFT
• Miriam Maritza Munoz

• Family Medicine Physician in Lakeside, CA
• Providers in Lakeside, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.