Provider Information for 1235422973
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Mr. ERAN MICHAEL MONTIEL IMF
Sex: Male
NPI: 1235422973
Last Updated: 2013-01-02
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1235422973 | ||||||||||||
| Enumeration Date | 2011-05-26 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 2865 LOGAN AVE SAN DIEGO, CA 92113-2411 United States Phone: | Fax: | ||||||||||||
| Primary Practice Address | 2865 LOGAN AVE SAN DIEGO, CA 92113-2411 United States Phone: 619-232-4357 | Fax: | ||||||||||||
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