Kenny Mendoza
Military Health Care Provider (Independent Duty Corpsman)

Address: 34800 Bob Wilson Dr, San Diego, CA 92134
Phone: 6195326911

Kenny Mendoza (NPI# 1841851631) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1841851631
Entity Type Individual
Full Name Kenny Mendoza
Gender Male
Practice Address 34800 Bob Wilson Dr
San Diego
CA 92134
Practice Telephone 6195326911
Mailing Address 34800 Bob Wilson Dr
San Diego
CA 92134
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2019-06-24
Last Update Date 2019-06-24

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 1710I1002X Military Health Care Provider · Independent Duty Corpsman Other Service Providers

Taxonomy Information

Taxonomy Code 1710I1002X
Grouping Other Service Providers
Classification Military Health Care Provider
Specialization Independent Duty Corpsman

Taxonomy Definition

A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.
Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new]

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1801492145 Felicia Leanna Roberts Military Health Care Provider 2267 Reed Ave, San Diego, CA 92109-5628 2020-12-10
1720684319 Brandon Young Military Health Care Provider 3401 Farenholt Ave Building 14, San Diego, CA 92134-0001 2020-12-08
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1255945069 Jeremy Lee Military Health Care Provider 509 Dennery Rd Apt 145, San Diego, CA 92154-8542 2020-08-31
1013520667 Rashaad Brown Military Health Care Provider 4454 Cherokee Ave Apt 2, San Diego, CA 92116-3611 2020-08-24
1932711934 Alvaro Daniel Macias Military Health Care Provider 8685 Rio San Diego Dr Apt 4344, San Diego, CA 92108-6560 2020-08-20
1689286189 Charles Luke Morris Military Health Care Provider 1675 Beta Ct, San Diego, CA 92126-7060 2020-08-18
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Office Location

Street Address 34800 BOB WILSON DR
City SAN DIEGO
State CA
Zip Code 92134

Providers in the same location

NPI Name Taxonomy Address Enumeration
1245235134 Willie S Chao Dentist 34800 Bob Wilson Dr, San Diego, CA 92134-1098 2005-06-16
1801492848 Hunter Brooks Zebley Student in an Organized Health Care Education/Training Program 34800 Bob Wilson Dr, San Diego, CA 92134-1098 2020-12-06
1396341459 Tasha Marie Wilson Registered Nurse 34800 Bob Wilson Dr, San Diego, CA 92134-1098 2020-12-04
1023625571 Samantha Savite Student in an Organized Health Care Education/Training Program 34800 Bob Wilson Dr, San Diego, CA 92134-1098 2020-09-29
1588270326 Angelina Yvette Harris Military Health Care Provider 34800 Bob Wilson Dr, San Diego, CA 92134-1098 2020-09-17
1275149296 Alexa Werner Physical Therapist 34800 Bob Wilson Dr, San Diego, CA 92134-1098 2020-09-16
1376157164 Toure Marlow Hinton Military Health Care Provider 34800 Bob Wilson Dr, San Diego, CA 92134-1098 2020-08-31
1316550106 John K Housinga Military Health Care Provider 34800 Bob Wilson Dr, San Diego, CA 92134-1098 2020-08-31
1073126249 Alfredo Carrillo Military Health Care Provider 34800 Bob Wilson Dr, San Diego, CA 92134-1098 2020-08-27
1326651647 Daniel Adan Denge Registered Nurse 34800 Bob Wilson Dr, San Diego, CA 92134-1098 2020-08-26
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1477178457 Joseph Hunter Sampson Military Health Care Provider 34101 Farenholt Ave #14, San Diego, CA 92134 2020-06-15
1508495201 Benjamin Michael Taylor Military Health Care Provider Naval Medical Center San Diego Psychiatry Residency Pgm, 34800 Bob Wilson Drive, San Diego, CA 92134 2020-04-04
1255870333 Dosh Page Physician Assistant Swmi Farenholt Avenue, Building 14, San Diego, CA 92134 2017-02-22
1417328063 Noem Clay Gallego Military Health Care Provider 34101 Building 14, Farenholt Avenue, San Diego, CA 92134 2015-10-08
1972999183 Justin Paul Lachney Military Health Care Provider 34101 Farenholt Avenue, San Diego, CA 92134 2015-04-14
1174963532 Ryan Anders Crane Otolaryngology Department of Otolaryngology - Nmc San Diego, 34800 Bob Wilson Dr, San Diego, CA 92134 2013-07-01
1447591268 Amy B. Cornell Student in an Organized Health Care Education/Training Program 34800 Bob Wilson Drive, San Diego, Ca, Apo, AA 92134 2013-03-04
1841562956 Christopher Patrick Androski Jr. Emergency Medical Technician, Basic Naval Medical Center San Diego 38400 Bob Wilson Dr, San Diego, CA 92134 2012-02-04
1164717740 Jason James Weiner Internal Medicine Dept of Internal Medicine, Division of Rheumatology, 34800 Bob Wilson Drive, San Diego, CA 92134 2011-06-13
1225320237 Kimberly Ann Thompson Student in an Organized Health Care Education/Training Program Navy Medical Center San Diego Gme Department, 34800 Bob Wilson Dr., San Diego, CA 92134 2011-05-09
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Competitor

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City SAN DIEGO
Zip Code 92134

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.