NPIMap

Organization Active NPI

Manuel F. Mendoza, M.D., Inc

Doing business as Mendoza Medical Clinic

  • Family Medicine Physician
  • Norwalk, CA
National Provider Identifier
1942416045
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MANUEL F. MENDOZA, M.D., INC
Doing business as
Mendoza Medical Clinic
Practice address
11735 Firestone Blvd
Norwalk, CA 90650
Phone
(562) 925-7716
Fax
(562) 867-0665
NPI assigned
May 15, 2007
Last updated
Feb 28, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Authorized official

Name
Mrs. Manuel F. Mendoza, MDNPI 1295824654
Title
Ceo
Phone
(562) 925-7716

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

11735 Firestone Blvd
Norwalk, CA 90650

Mailing address

11735 Firestone Blvd
Norwalk, CA 90650
Phone (562) 925-7716

Other identifiers 1

IdentifierTypeStateIssuer
W21839OtherCAMEDICARE ID

Other names 1

  • Mendoza Medical Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080311000636 CA Part B Supplier - Clinic/Group Practice 9537244769 Receives reassigned benefits from 8 practitioners
Practice locations: Norwalk, CA

National Provider Directory

National Provider Directory
Tax ID family
Manuel F Mendoza MD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

16660 Paramount Blvd
Ste 306
Paramount, CA 90723
Phone (562) 633-1404

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677542400000",
    "number": "1942416045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11735 FIRESTONE BLVD",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "90650",
            "telephone_number": "562-925-7716",
            "fax_number": "562-867-0665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11735 FIRESTONE BLVD",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "90650",
            "telephone_number": "562-925-7716",
            "fax_number": "562-867-0665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANUEL F. MENDOZA, M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A",
        "authorized_official_last_name": "MENDOZA",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "562-925-7716",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "W21839",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mendoza Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Norwalk, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.