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General NPI Number Information
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NPI Number | 1407792450
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Entity Type | Individual
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Provider Name | LENNIN MONTALVO
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Gender | Male
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Dates
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Enumeration Date | 04/23/2026
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Last Update Date | 04/23/2026
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Provider Practice Location Address
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Address Line | 5340 W BUCKEYE RD
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City | PHOENIX
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State | AZ
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Zip | 85043-4700
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Country | US
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Telephone | 602-233-2117
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Fax |
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Provider Business Mailing Address
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Address Line | 6931 W ANTELOPE DR
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City | PEORIA
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State | AZ
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Zip | 85383-6025
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Country | US
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Telephone | 661-970-6667
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | RHP100914
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License Number State | CA
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