Vicente Gabriel Monteiro Mendes, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA57011 Issued in CA

Practice address

34101 Farenholt Ave
Building 14
San Diego, CA 92134-7000

Phone

(619) 532-5544

NPI assigned

Nov 3, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1320278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1144507237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 788250",
            "city": "TWENTYNINE PALMS",
            "state": "CA",
            "postal_code": "922788250",
            "telephone_number": "760-917-3879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34101 FARENHOLT AVE",
            "address_2": "BUILDING 14",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921347000",
            "telephone_number": "619-532-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDES",
        "first_name": "VICENTE",
        "middle_name": "GABRIEL MONTEIRO",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-03",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA57011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sabrina Menchaca
• Christian Mendaros Mendaros
• Danielle Mendell, HHP, CMT
• Sarah Mendenhall, DPT
• Chantal Marie Mendes, MD
• Ivanna Z Mendez Castillo, NA
• Brandon Agustin Mendez Garfias
• Ileana Mendez Ledezma, NHE
• Mendez Medical Center Inc
• Leslie Mendez Motta

• Physician Assistant in San Diego, CA
• Providers in San Diego, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.