MEDICARE: MARCO ALONZO MONTES

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	106S00000X	Behavior Technician		CA

General Provider Information

NPI Number	:	1952070658
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCO ALONZO MONTES

Provider Business Mailing Address
First Line	:	SOUTH BAY (SAN JOSE): DEPT LA 22763
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91185-0001
Country	:	US
Telephone Number	:	848-200-2869
Fax Number	:

Provider Business Practice Location Address
First Line	:	SOUTH BAY(SAN JOSE): DEPT LA 22763
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91185-5700
Country	:	US
Telephone Number	:	848-200-2869
Fax Number	:

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

Provider Enumeration Date	:	09/07/2021
Last Update Date	:	10/26/2022

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Directions to “ MARCO ALONZO MONTES ” Practice Location

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