Healthcare Provider Details

I. General information

NPI: 1467209015
Provider Name (Legal Business Name): MR. JOHN ERIK MONTANO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2024
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

459 N GILBERT RD STE A213
GILBERT AZ
85234-4771
US

IV. Provider business mailing address

459 N GILBERT RD STE A213
GILBERT AZ
85234-4771
US

V. Phone/Fax

Practice location:
  • Phone: 480-810-4997
  • Fax: 480-214-3178
Mailing address:
  • Phone: 480-810-4997
  • Fax: 480-214-3178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: