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NPI Code Detail

MEDICARE: DR. ROBERTO E. MONTALVO PH.D.

MEDICARE: DR. ROBERTO E. MONTALVO PH.D.
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
1103T00000XPsychologistPSY8041CA

General Provider Information

NPI Number : 1629095211
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERTO E. MONTALVO PH.D.
Provider Business Mailing Address
First Line : 38970 BLACOW RD
Second Line : SUITE C
City : FREMONT
State : CA
Zip : 94536-7380
Country : US
Telephone Number : 510-796-3034
Fax Number :
Provider Business Practice Location Address
First Line : 38970 BLACOW RD
Second Line : SUITE C
City : FREMONT
State : CA
Zip : 94536-7380
Country : US
Telephone Number : 510-796-3034
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2006
Last Update Date : 07/08/2007

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