Healthcare Provider Details

I. General information

NPI: 1306226188
Provider Name (Legal Business Name): CAROL'S BELSAI MONTES-ROUSE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2015
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W HOSPITAL RD
FRENCH CAMP CA
95231-9693
US

IV. Provider business mailing address

751 S BASCOMAVE
SAN JOSE CA
95128-1450
US

V. Phone/Fax

Practice location:
  • Phone: 209-468-6428
  • Fax:
Mailing address:
  • Phone: 818-257-9082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA183207
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036156308
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: