Basic Information
| Provider Information | |||||||||
| NPI: | 1174882450 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MENDOZA | ||||||||
| FirstName: | LILIANA | ||||||||
| MiddleName: | AROSEMENA | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4234 RIVERWALK PARKWAY SUITE 230 | ||||||||
| Address2: | PACIFIC PULMONARY MEDICAL GROUP | ||||||||
| City: | RIVERSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9517813672 | ||||||||
| FaxNumber: | 9517810365 | ||||||||
| Practice Location | |||||||||
| Address1: | 4234 RIVERWALK PARKWAY SUITE 230 | ||||||||
| Address2: | PACIFIC PULMONARY MEDICAL GROUP | ||||||||
| City: | RIVERSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9517813672 | ||||||||
| FaxNumber: | 9517810365 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2012 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 5101020967 | MI | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 20A15446 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RP1001X | 20A15446 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207RC0200X | 20A15446 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine |
No ID Information.