Provider Demographics
NPI:1194798496
Name:MENDOZA, LEONARDO CESAR III (MD)
Entity type:Individual
Prefix:DR
First Name:LEONARDO
Middle Name:CESAR
Last Name:MENDOZA
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1751 W ORANGE GROVE RD STE 111
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-1192
Mailing Address - Country:US
Mailing Address - Phone:520-593-7761
Mailing Address - Fax:520-593-7764
Practice Address - Street 1:1751 W ORANGE GROVE RD STE 111
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-1192
Practice Address - Country:US
Practice Address - Phone:520-593-7761
Practice Address - Fax:520-593-7764
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ35869204C00000X, 207R00000X
AZ35867207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ111993Medicare PIN