OrganizationVictor MedinaDentistDental ProvidersPractice AddressIgnacio Comonfort 9379, Tijuana, Baja California 22010 (Mexico)(619) 488-3200PECOS EnrollmentBased on the most recent information from CMS, provider Victor Medina 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 ID1770132631Provider TypeOrganizationFull NameVictor MedinaSubpartNoEnumeration Date9/4/2019Last Updated9/4/2019Contact InformationPractice LocationPractice AddressIgnacio Comonfort 9379, Tijuana, Baja California 22010 (Mexico)Phone(619) 488-3200Fax(866) 272-6924Mailing LocationMailing Address4275 Executive Sq Ste 200, La Jolla, CA 92037-1476PhoneUnlisted PhoneFaxUnlisted FaxAuthorized OfficialNameMedina, Victor (Dentits)Phone(619) 488-3200Provider TaxonomiesCodeDescriptionLicenseCode1223G0001XPrimaryDescriptionDentistDental ProvidersLicenseUnlisted Issuer