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General NPI Number Information
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NPI Number | 1831737162
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Entity Type | Individual
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Provider Name | MARTHA MONTEALEGRE NP
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Gender | Female
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Dates
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Enumeration Date | 12/17/2019
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Last Update Date | 12/17/2019
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Provider Practice Location Address
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Address Line | 101 E BEVERLY BLVD
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City | MONTEBELLO
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State | CA
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Zip | 90640-4300
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Country | US
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Telephone | 323-722-7418
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Fax |
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Provider Business Mailing Address
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Address Line | 12501 BEVERLY BLVD
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City | WHITTIER
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State | CA
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Zip | 90601-3039
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Country | US
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Telephone | 323-350-3662
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 95013504
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License Number State | CA
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