OrganizationRandal MejiaDentistDental ProvidersPractice Address9910 Calle Rufino Tamayo Ste 04, Tijuana, Baja California 22010 (Mexico)(619) 488-3200PECOS EnrollmentBased on the most recent information from CMS, provider Randal Mejia does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1427633528Provider TypeOrganizationFull NameRandal MejiaSubpartNoEnumeration Date3/10/2021Last Updated3/10/2021Contact InformationPractice LocationPractice Address9910 Calle Rufino Tamayo Ste 04, Tijuana, Baja California 22010 (Mexico)Phone(619) 488-3200Fax(619) 908-1095Mailing LocationMailing Address4275 Executive Sq Ste 200, La Jolla, CA 92037-1476Phone(619) 488-3200Fax(619) 908-1095Authorized OfficialNameMejia, Randal (Dentist)Phone(619) 488-3200Provider TaxonomiesCodeDescriptionLicenseCode1223G0001XPrimaryDescriptionDentistDental ProvidersLicenseUnlisted Issuer