Healthcare Provider Details

I. General information

NPI: 1265748610
Provider Name (Legal Business Name): MR. ALAN MONTES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2010
Last Update Date: 03/10/2021
Certification Date: 03/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 N LA CIENEGA BLVD STE 200
BEVERLY HILLS CA
90211-2285
US

IV. Provider business mailing address

2225 S PALM AVE
ALHAMBRA CA
91803-3832
US

V. Phone/Fax

Practice location:
  • Phone: 310-657-9353
  • Fax:
Mailing address:
  • Phone: 626-416-8534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number100412
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number085582
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: