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General NPI Number Information
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NPI Number | 1518141993
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Entity Type | Individual
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Provider Name | JR MONTEMAYOR
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Gender | Male
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Dates
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Enumeration Date | 12/20/2007
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Last Update Date | 12/20/2007
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Provider Practice Location Address
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Address Line | 34800 BOB WILSON DR
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City | SAN DIEGO
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State | CA
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Zip | 92134-1098
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Country | US
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Telephone | 619-532-8771
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Fax |
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Provider Business Mailing Address
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Address Line | 2711 RIDGESIDE PL
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City | SPRING VALLEY
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State | CA
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Zip | 91977-6824
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Country | US
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Telephone | 619-713-1434
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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 | 2471C3401X
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Taxonomy Name | Computed Tomography Radiologic Technologist
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License Number |
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License Number State |
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