MEDICARE: VICTOR M MONJARAZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist
2	225700000X	Massage Therapist	87490	CA

General Provider Information

NPI Number	:	1396470944
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTOR M MONJARAZ

Provider Business Mailing Address
First Line	:	5834 ARLINGTON BLVD
Second Line	:
City	:	RICHMOND
State	:	CA
Zip	:	94805-1133
Country	:	US
Telephone Number	:	510-309-5858
Fax Number	:

Provider Business Practice Location Address
First Line	:	5834 ARLINGTON BLVD
Second Line	:
City	:	RICHMOND
State	:	CA
Zip	:	94805-1133
Country	:	US
Telephone Number	:	510-309-5858
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2022
Last Update Date	:	07/19/2022

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Directions to “ VICTOR M MONJARAZ ” Practice Location

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