Active NPI
Geraldric Mendoza
- Phlebotomy Technician
- Milpitas, CA
National Provider Identifier
1699590646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Phlebotomy Technician
- License
- CPT-022613187
- Practice address
- 1652 Quail Dr
Milpitas, CA 95035-4720 - Phone
- (408) 775-5914
- NPI assigned
- Nov 15, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Phlebotomy Technician | 246RP1900X | CPT-022613187 | CA | Primary |
Addresses
Primary practice location
1652 Quail Dr
Milpitas, CA 95035-4720
Mailing address
1652 Quail Dr
Milpitas, CA 95035-4720
Phone (408) 775-5914
Other names 1
- Geraldric Mendoza
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CPT-022613187 | CA | MD | Phlebotomy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1731628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731628800000",
"number": "1699590646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1652 QUAIL DR",
"city": "MILPITAS",
"state": "CA",
"postal_code": "950354720",
"telephone_number": "408-775-5914"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1652 QUAIL DR",
"city": "MILPITAS",
"state": "CA",
"postal_code": "950354720",
"telephone_number": "408-775-5914"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDOZA",
"first_name": "GERALDRIC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-11-15",
"last_updated": "2024-11-15",
"certification_date": "2024-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "246RP1900X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Phlebotomy",
"state": "CA",
"license": "CPT-022613187",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "GERALDRIC",
"last_name": "MENDOZA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Milpitas, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.