Healthcare Provider Details

I. General information

NPI: 1588590236
Provider Name (Legal Business Name): MONTANA BILLING & HOLDINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5634 N PERSHING AVE STE B7
STOCKTON CA
95207-4906
US

IV. Provider business mailing address

5634 N PERSHING AVE STE B7
STOCKTON CA
95207-4906
US

V. Phone/Fax

Practice location:
  • Phone: 350-203-5292
  • Fax:
Mailing address:
  • Phone: 350-203-5292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: VENTURA ENRIQUEZ
Title or Position: CEO
Credential:
Phone: 350-203-5292