Jorge Camilo Mendez Vides

Primary specialty

Basic Emergency Medical TechnicianTaxonomy code 146N00000X

License

E144860 Issued in CA

Practice address

18321 Clark St
Tarzana, CA 91356-3501

Phone

(818) 708-5172

NPI assigned

Dec 6, 2021

Sex

Male

Sole proprietor

No

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

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": "1638748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1679231807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18321 CLARK ST",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563501",
            "telephone_number": "818-708-5172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18321 CLARK ST",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563501",
            "telephone_number": "818-708-5172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDEZ VIDES",
        "first_name": "JORGE",
        "middle_name": "CAMILO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-06",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "CA",
            "license": "E144860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aury Esther Melo
• Laura A Melton
• Arnoldo Alexander Mena
• Loretta Menchaca
• Brenda Ellen Menchel
• Kasandra Mendez
• Laura Yvette Mendez, MA
• Andres Mendoza
• Jessica Mendoza
• Leslie Aida Mendoza, M.A.

• Basic Emergency Medical Technician in Tarzana, CA
• Providers in Tarzana, CA by specialty
• Basic Emergency Medical Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; 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.