Provider Demographics
NPI:1902149503
Name:MENDIOLA, MARIA CECILIA SIOCO (C-SA)
Entity Type:Individual
Prefix:MRS
First Name:MARIA CECILIA
Middle Name:SIOCO
Last Name:MENDIOLA
Suffix:
Gender:F
Credentials:C-SA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:280 PALE SAN VITORES ROAD
Mailing Address - Street 2:
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96913
Mailing Address - Country:US
Mailing Address - Phone:671-647-4542
Mailing Address - Fax:671-647-4558
Practice Address - Street 1:280 PALE SAN VITORES ROAD
Practice Address - Street 2:
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913
Practice Address - Country:US
Practice Address - Phone:671-647-4542
Practice Address - Fax:671-647-4558
Is Sole Proprietor?:No
Enumeration Date:2013-04-02
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist