Most Relevant Information
Provider Data
| NPI Number: | 1003512310 |
| Provider Name: | ALBERT SOARES MENDONCA |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/07/2023 |
| Last Updated: | 10/11/2024 |
Provider Practice Location
40 W G ST
LOS BANOS
CA
936353657
Practice Location Phone/Fax
| Phone: | 2097106100 |
| Fax: |
Provider Mailing Location
27425 GUN CLUB RD
GUSTINE
CA
953229709
Provider Mailing Phone/Fax
| Phone: | 2096785502 |
| Fax: |