Individual provider · Type 1 NPI
Harold Lisandro Mendoza Moreno, RSA
Surgical Physician Assistant · Plainfield, IL
NPI number
1366879330
Active
Practice location
26536 W Countryside Ln
Plainfield, IL 60585-2324
Fax (779) 234-9841
Mailing address
PO Box 163
Oswego, IL 60543-0163
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Physician Assistant Primary | 363AS0400X | 238.000377 (IL) |
| Surgical Assistant | 246ZC0007X | 238.000377 (IL) |
Surgical Physician Assistant: Definition to come...
Another provider at this address
Other surgical physician assistant providers in Plainfield
About NPI 1366879330
Harold Lisandro Mendoza Moreno, RSA's National Provider Identifier is 1366879330, issued on Oct 4, 2013. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Plainfield, IL. The record was last updated on Mar 19, 2024.