Doctor Name: | DR. CRISTOBAL IVAN MENDEZ RUIZ |
NPI Number: | 1326244674 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 16796 |
Business Practice Address: | Calle Andres Mendez Liciaga #6 A San Sebastian, PR - 00685 |
Business Phone Number: | 7875850450 |
Business Fax Number: | 7878962160 |
Mailing Address: | Calle Andres Mendez Liciaga, #6 A SAN SEBASTIAN |
State: | PR |
Postal Code: | 00685 |
Phone Number: | 7875850450 |
Fax Number: | 7878962160 |
NPI Enumeration Date: | 06/25/2007 |
NPI Last Update Date: | 07/29/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 16796 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |