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Mendo Lake Urologic Medical Group, Inc
Specialist in Ukiah, California
NPI 1083646525

Mendo Lake Urologic Medical Group, Inc is a Specialist based in Ukiah, CA. Mendo Lake Urologic Medical Group, Inc practices in Ukiah, CA. The NPI Number for Mendo Lake Urologic Medical Group, Inc is 1083646525 and holds a License No. A24853 (California).

The current practice location address for Mendo Lake Urologic Medical Group, Inc is 246 Hospital Dr, Ukiah, CA and can be reached out via phone at 707-462-1928 and via fax at 707-462-8642.

Location: 246 Hospital Dr, Ukiah, CA, 95482-4533
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1083646525
Provider Name
Mendo Lake Urologic Medical Group, Inc
Credential
Provider Entity Type
Organization
Address
246 Hospital Dr, Ukiah, CA, 95482-4533
Phone Number
707-462-1928
Fax Number
707-462-8642
Provider Enumeration Date
07/07/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
ZZZ74887Z 05 CA
institution
Provider Business Practice Location Address Details
Address
246 Hospital Dr
City
Ukiah
State
California
Zip
95482-4533
Phone Number
707-462-1928
Fax Number
707-462-8642
person
Provider Business Mailing Address Details
Address
246 Hospital Dr
City
Ukiah
State
California
Zip
95482-4533
Phone Number
707-462-1928
Fax Number
707-462-8642
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
A24853 (California)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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