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General NPI Number Information
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NPI Number | 1821290206
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Entity Type | Individual
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Provider Name | BELLA GLORIA MONTGOMERY N.P.
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Gender | Female
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Dates
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Enumeration Date | 06/05/2007
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Last Update Date | 10/15/2015
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Provider Practice Location Address
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Address Line | 150 VALPREDA RD NCHS-SAN MARCOS
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City | SAN MARCOS
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State | CA
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Zip | 92069-2973
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Country | US
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Telephone | 619-246-8404
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Fax |
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Provider Business Mailing Address
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Address Line | 4575 67TH ST
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City | LA MESA
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State | CA
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Zip | 91941-5834
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Country | US
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Telephone | 619-465-5219
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN318912
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License Number State | CA
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