Healthcare Provider Details

I. General information

NPI: 1366671844
Provider Name (Legal Business Name): MR. MONTE WILLIAMS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2009
Last Update Date: 07/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

855 VETERANS BLVD
REDWOOD CITY CA
94063-1712
US

IV. Provider business mailing address

610 GRAND FIR AVE APT 11
SUNNYVALE CA
94086-7941
US

V. Phone/Fax

Practice location:
  • Phone: 650-817-9070
  • Fax: 650-817-9074
Mailing address:
  • Phone: 650-817-9070
  • Fax: 650-817-9074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: