Provider Demographics
NPI:1548719537
Name:MENDIA, ELIZABETH URETA (LE)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:URETA
Last Name:MENDIA
Suffix:
Gender:F
Credentials:LE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7927 PAINTER AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90602-2479
Mailing Address - Country:US
Mailing Address - Phone:562-324-5236
Mailing Address - Fax:
Practice Address - Street 1:7927 PAINTER AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-2479
Practice Address - Country:US
Practice Address - Phone:562-324-5236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-02
Last Update Date:2016-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL9524246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other