Healthcare Provider Details

I. General information

NPI: 1700716321
Provider Name (Legal Business Name): MYLES MONTON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26302 LA PAZ RD STE 105
MISSION VIEJO CA
92691-5327
US

IV. Provider business mailing address

26302 LA PAZ RD STE 105
MISSION VIEJO CA
92691-5327
US

V. Phone/Fax

Practice location:
  • Phone: 949-206-1700
  • Fax:
Mailing address:
  • Phone: 916-716-5332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number310565
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: