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General NPI Number Information
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NPI Number | 1194395137
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Entity Type | Organization
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Legal Business Name | MONTERO MEDICAL CORPORATION
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Dates
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Enumeration Date | 07/01/2021
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Last Update Date | 10/01/2021
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Provider Practice Location Address
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Address Line | 2362 N OXNARD BLVD STE 102
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City | OXNARD
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State | CA
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Zip | 93036-2053
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Country | US
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Telephone | 409-877-3191
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Fax |
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Provider Business Mailing Address
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Address Line | 2362 N OXNARD BLVD STE 102
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City | OXNARD
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State | CA
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Zip | 93036-2053
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Country | US
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Telephone | 805-946-1634
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. WINSTON MONTERO
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Credential | MD
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Telephone | 805-946-1634
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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