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General NPI Number Information
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NPI Number | 1780808030
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Entity Type | Individual
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Provider Name | ALEX MONTEZ P.A.
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Gender | Male
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 375 ROLLING OAKS DR SUITE 100
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City | THOUSAND OAKS
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State | CA
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Zip | 91361-1023
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Country | US
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Telephone | 805-497-7775
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Fax | 805-557-1074
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Provider Business Mailing Address
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Address Line | PO BOX 940838
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City | SIMI VALLEY
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State | CA
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Zip | 93094-0838
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Country | US
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Telephone | 805-433-7777
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Fax | 805-433-7607
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA10386
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License Number State | CA
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