Healthcare Provider Details

I. General information

NPI: 1508816414
Provider Name (Legal Business Name): JORGE FRANCISCO MONTOY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 06/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2514 JENSEN AVE #102
SANGER CA
93657-2250
US

IV. Provider business mailing address

2514 JENSEN AVE #102
SANGER CA
93657-2250
US

V. Phone/Fax

Practice location:
  • Phone: 559-875-6970
  • Fax: 559-875-1469
Mailing address:
  • Phone: 559-875-6970
  • Fax: 559-875-1469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG46427
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: