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General NPI Number Information
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NPI Number | 1982415717
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Entity Type | Individual
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Provider Name | JOEL MARK MONTEMAYOR ABO,NCLE,LDO
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Gender | Male
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Dates
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Enumeration Date | 01/20/2025
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Last Update Date | 04/04/2025
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Provider Practice Location Address
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Address Line | 1725 W HUNT HWY
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City | SAN TAN VALLEY
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State | AZ
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Zip | 85143-5203
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Country | US
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Telephone | 480-358-4346
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Fax |
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Provider Business Mailing Address
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Address Line | 33559 N NORTH BUTTE DR
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City | QUEEN CREEK
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State | AZ
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Zip | 85144-6388
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Country | US
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Telephone |
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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 | 156FX1800X
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Taxonomy Name | Optician
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License Number | 2369I
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 2369I
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License Number State | AZ
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